Leukocyte Index Of Intoxication Research Articles

Searching for methods to predict septic complications in surgical patients

Aim. To assess the significance of acute stage reactants as the marker for purulent complications in surgical patients.Methods. We analyzed the results of treatment of 228 patients with purulent and inflammatory diseases of soft tissues, treated in 2011-2014. Acute phase reactants: C-reactive protein, albumin and fibrinogen were measured starting from the day of admission and surgical treatment and during the next 7 days. The control group (112 patients) included patients whowere treated conventionally by gauze bandage with water-soluble ointments and antiseptic solutions and broad-spectrum antibiotics. In the study group (116 patients) topical treatment of wounds was performed using «Poliderm» bandages.Results. Application of the «Poliderm» combined dressing reduced the wounds clearance term from 4.3±0.5 to 3.2±0.4 days, active inflammation term from 8.8±1.3 to 6.4±0.7 days, epithelialization of the wound from 10.1±0.8 to 8.4±0.6 days. C-reactive protein level was 87.3±4.3 g/l at the day of admission and decreased by day 7 to 34.13±1.2 g/l, compared to 51.83±3.6 g/l on the 7th day in the control group. Albumin level was 42.73±3.7 g/l in the study group with further decrease to 40.33±1.7 g/l on the 2nd and subsequent increase up to 45.13±1.3 g/l on the day 7. Patients of the control group had albumin level decreased on the 2nd and 3rd days with further increase up to 41.73±2.1 g/l on the day 7. At the treatment start, leukocyte intoxication index was 5.923±0.4 in the main group and 5.873±0.3 in the control group. On the 2nd day, this parameter decreased to 5.12 in the main group and to 5.41 in the control group.Conclusion. Measuring the levels of acute phase reactants (C-reactive protein, albumin, etc.) allows to assess the clinical course of a purulent and inflammatory disease, to register the good treatment effect on the 1-2nd day of treatment, even before the significant clinical changes, changes in the body temperature, white blood cell counts, erythrocyte sedimentation rate.

Influence of drug correction options of postoperative motility disorders of the gastrointestinal tract on inflammatory and anti-inflammatory markers

Introduction. Postoperative dysmotility of the gastrointestinal tract is a common complication after operations on the abdominal cavity. Intestinal inflammatory response plays an important role in the development of postoperative motility disorders. Materials and methods. After Local Ethics Committee approval and obtaining informed consent, 103 patients were prospectively divided into 4 groups depending on the characteristics of post-operative intensive care. In the 1 (control) group (n=27), patients after operation received stimulation of the gastrointestinal tract with metoclopramidum and neostigminum. In group 2 (n=24), patients received L-arginine and metoclopramidum. In the group 3 (n=25) patients received metoclopramidum and simeticonum. In group 4 (n=27), patients received L-arginine, metoclopramidum and simeticonum. Markers of inflammation (leukocyte levels, fibrinogen, IL-1α, TNFα, IL-10, the calculation of leukocyte index of intoxication) were studied preoperatively, after 1,3 and 7 days. Results and Conclusion. Pathological process in the abdomen accompanied by the development of postoperative gastrointestinal dysmotility, increase in the number of white blood cells to 58.8% (p <0.001) and fibrinogen to 55.5% (p<0.001), imbalance of the inflammatory response of the body in the form of increased pro-inflammatory IL-1α by 25.1% (p = 0.047) with a simultaneous decrease the level of TNF more than 400% (p <0,001), before surgery. Group 1 patients inflammatory response persisted for more than 7 days after the operation and leads to depletion of proinflammatory cytokine system, as indicated by the levels of pro-inflammatory IL-1α and TNFα, whose values were below normal at 503% (p <0.001) and 57.9% (p <0.001). When using metoclopramide and L-arginine manifestations of inflammatory response persisted throughout the observation period, but progressively, and at 7 days after operation were smaller than in the other groups. So, in group 2 at 7 days after operation the level of IL-1α was the highest, exceeding the value of 1 to 367% (p <0.001), 3 - by 314% (p <0.001), 4 - 400% (p <0.001). At the same, TNFα levels in group 2 did not differ statistically significantly from preoperative. In group 1 at 7 days after surgery there was increase of anti-inflammatory IL-10 level is above normal and figures 3 and 4 groups at 78.2% (p <0.001) and 124% (p <0.001) and 60, 2% (p = 0.001). The most rapid restoration of peristalsis was using metoclopramide and L-arginine. So, in group 2 independent carminative observed after 2.22 days after operation that 21.8% (p = 0.001) was lower than in group 1, 29.7% (p <0.001) - 3 groups, 26 6% (p = 0.003) - 4 group. This reduces the length of stay in ICU. 100% of patients 3 and 4 and the absolute majority of the patients 1 and 2 groups at 28 days after surgery VIII reached the level of quality of life scale RLAS

Minimally invasive surgical treatment of patients with bilateral pulmonary tuberculosis complicated with pleural empyema.

Objective of our study was to increase the effectiveness of surgical treatment of bilateral destructive pulmonary tuberculosis complicated by pleural empyema by using VTS-technologies. The study was done in Dnepropetrovsk regional clinical therapeutic and prophylactic association Phthisiology in the period from 2008 to 2013. A retrospective analysis of 43 cases of bilateral destructive pulmonary tuberculosis complicated by pleural empyema on one side and dissemination focus or limited destructive process on contralateral side has been performed. Selected cases were divided into 2 groups: main (eighteen cases where the following procedures were done: performed transsternal occlusion of the main bronchus, sanation of empyema cavity using videothoracosopy, in 30-45 days followed by pleuropneumectomy with usage of minithoracothomy) and control (nineteen cases who had undergone drainage of the empyema cavity, sanation, in 45-60 days followed by pleuropmeumectomy with usage of anterolateral access). The distribution of main and control groups for analyzed parameters was representative. Sanation of pleural cavity with videothoracosopy usage compared with Bulau’s drainage provides better antibacterial effect, effective sanitation of the pleural cavity as evidenced by following changes: significant decrease in the number of microbial cells; normalization of total white blood cells count and rod-shaped granulocytes in the peripheral blood 10 days after treatment; normalization of leukocyte intoxication index. The use of minimally invasive surgical treatment allowed to reduce intraoperative complications by 2 times, amount of intraoperative blood loss and hemotrasfusions by 1.5 times, postoperative mortality by 2.5 times. Pleural cavity sanation with videothoracoscopy usage with following pneumoectomy leads to reduce in the incidence and severity of postoperative complications. The most promising is stage-by-stage surgical approach with consecutive use of previous transsternal occlusion of the main bronchus and pulmonary artery branch with videothoracoscopy sanation of empyema cavity.

Efferent detoxification methods and evaluation of the intensive therapy efficacy in children with bacterial toxemia

The main problem of severe bacterial infections intensive therapy in children is toxemia, disorder of hemodynamic and oxygen transport.Aim. The aim of the work was to study the features of hemodynamics, oxygen transport, the level of toxemia during bacterial intoxication treatment in children, including discrete plasmapheresis.Methods and results. The study included 28 children with severe bacterial infections. We found that the inclusion of efferent methods of intensive care, such as a discrete plasmapheresis, helped to reduce circulation hyperdynamia and restore a balanced mode of delivery and oxygen consumption within 24 hours after the plasmapheresis session.Conclusion. Reduction of toxemia was noted after plasmapresis, which was confirmed by a significant decreasing in the toxicity markers level – middle molecules in the blood and leukocyte index of intoxication.

Влияние миниинвазивных колостом на микробную обсемененность брюшной полости и развитие интоксикационного синдрома у больных раком прямой кишки, осложненным острой непроходимостью

The article studies the influence of proximal colostomy formed through minimal access for microbial contamination of the abdominal cavity during the radical phase of treatment and the dynamics of the inflammatory changes and intoxication syndrome in patients with rectal cancer complicated by acute obstruction. The research on microbial contamination of the abdominal cavity was made in 32 patients, including 15 patients in whom obstruction was resolved conservatively and 17 patients in whom was made a proximal colostomy through mini-invasive access to eliminate acute obstruction. In 30 patients were investigated acute phase proteins and determined the level of toxemia available by calculation leukocyte index of intoxication. Blood sampling was carried out in patients with acute intestinal obstruction directly before applying the proximal colostomy, and before the second - a radical step treatment in 7-10 days. Found that the imposition of the proximal colostomy through minimal access does not lead to an increase in microbial contamination of the abdomen; helps reduce the level of acute phase proteins, the level of general toxemia and reduces the risk of postoperative inflammatory complications before performing radical phase of treatment.

Effect of interleukin-1β on peripheral blood leukocytes in rats with various behavioral characteristics during acute stress.

We studied the effect of a pro-inflammatory cytokine IL-1β (5 μg/kg intraperitoneally) on blood leukocytes in Wistar rats various behavioral characteristics during acute emotional stress (1-h immobilization with simultaneous delivery of subthreshold electrocutaneous stimulation). Stress exposure was accompanied by a decrease in the total number of peripheral blood leukocytes in rats. Active animals were characterized by the increase in neutrophil count during stress. The number of eosinophils in passive specimens was shown to decrease under these conditions. Emotional stress was followed by a decrease in the lymphocyte index (by Shaganin) of active rats and increase in the leukocyte intoxication index (according to Kalf-Kalif) of passive specimens. Stress-induced changes in leukocytes differed after pretreatment with IL-1β. The number of blood leukocytes increased in animals receiving a cytokine injection before stress exposure. Exogenous IL-1β inverted (in active rats) or prevented (in passive specimens) a change in the percentage of various types of blood leukocytes, which was found after stress exposure. These data contribute to the understanding of peripheral mechanisms for the involvement of immunomodulatory cytokines in the systemic organization of physiological functions in specimens with different prognostic resistance to a similar stress exposure.

Prevention of pregnancy loss after appendectomy

Aim. To optimize preventive measures for miscarriage after appendectomy based on a study of the gestation course pathogenetic features in acute appendicitis. Methods. 78 pregnant women who had underwent surgery for acute appendicitis during gestation (gestation term from 4 to 30 weeks) were examined. The control group consisted of healthy 37 women with normal gestation. Serum prolactin level was measured by ELISA. Leukocyte intoxication index, combined endotoxin titre, coagulation tests (fibrinogen, soluble fibrin monomers, activated partial thromboplastin time, fibrinolysis time) were also examined. serum cytokine levels (interleukine-1β, -2, -4, -6, interferon γ, tumor necrosis factor α) were measured by solid-phase enzyme immunoassay. Patients of comparison group (n=42) received standard treatment targeted on pregnancy prolongation after the surgery. Discrete plasmapheresis was added to treatment offered for patients of the main group (n=36) at 3rd and 5th days after the appendectomy. Results. Endogenous intoxication syndrome development in association with hyper coagulation and simultaneous fibrinolysis inhibition and increase of paracoagulation products levels combined with pro-inflammatory cytokines level increase was noted in pregnant patients with appendicitis. Prolactin level increased by 1.5-1.8 times at 5-7 days after surgery with further decrease at 10-14 day accompanied by risk of miscarriage. The use of discrete plasmapheresis at 3rd and 5th days after surgery contributes to maintaining stable concentrations of prolactin in pregnant women in all terms during the postoperative period, as well as endogenous intoxication indicators decrease, hemostasis and cytokine profile normalization, allowing to increase the rate of successful pregnancy outcomes after appendectomy. Conclusion. Addition of plasmapheresis as a component of complex treatment in pregnant women after appendectomy allowed to reduce the risk of miscarriage by 4 times, and the rate of miscarriage by twice, suggesting this method as a safe and effective way to prevent miscarriage.

HEMATOLOGICAL PARAMETERS OF ENDOGENOUS INTOXICATION FOR ASSESSING THE SEVERITY OF COURSE AND EARLY DIAGNOSTICS OF PYO-INFLAMMATORY COMPLICATIONS IN PATIENTS WITH LONG BONE FRACTURES

314 patients were examined. The dynamics of changes in hematological parameters for assessing the severity of endogenous intoxication and prediction of postoperative pyo-inflammatory complications in surgical treatment of fractures of long bones has been studied. It is established that syndrome of endogenous intoxication by patients with fractures of long bones develops in the first 2 days from the time of injury There is risk of developing infectious complications of postoperative wound by patients whose hematologic indices are not reduced to 3 days before the normal range. The value of the index-day operations above the normal values increases the risk of infectious complications in the wound during subsequent treatment. Infectious inflammation in postoperative wound is characterized by normal LII values and GPI. To assess the risk of complications it is necessary to carry out the KLA at 3nd and 12th days of the postoperative period concerning LII (leukocyte index of intoxication), GPI (hematologic toxicity index), PTI (indicator of the severity of intoxication). Since the various indices of intoxication have predictive value in a certain period of time of injury

Peculiarities of acute phase response in various types of uterine appendages inflammation

Concentrations of some acute phase proteins (alpha-1-antitrypsin or AT; alpha-2-macroglobulin or MG; pregnancy associated alpha-2-glycoprotein or PAG) and lactoferrin (Lf) were studied in blood serum of 82 women with various types of uterine append-ages inflammation. The data obtained have been compared with conventional and commonly used laboratory indices of inflammato-ry response such as fibrinogen (Fbg) and leukocyte intoxication index. Our findings confirmed significant role of macroglobulin family proteins in the development of acute phase inflammation. Associated tendencies in changes of acute phase proteins concen-trations in various types of uterine appendages inflammation have been identified and recommended to be employed in clinical prac-tice for making differential diagnosis and for selection of optimal therapeutic approach.

Neutrophil count in the blood and bone marrow after surgical treatment of focal pancreonecrosis with the use of a plasma scalpel

It is shown that as early as in the first few hours after induction of focal pancreonecrosis dogs exhibit a standard leukocyte stress reaction, the major manifestation of which are neutrophilic leukocytosis, relative and absolute lymphocytopenia and eosinopenia, as well as a deviation of the neutrophil count to the left and an increase in the leukocyte intoxication index. Resection of the pancreas with a plasma scalpel stimulates further development of this response.

Leukocyte intoxication index of oncological practice

In practical oncology, the term "intoxication" is often used to characterize the severity of the condition. Its manifestations are nausea, vomiting, tachycardia, decreased appetite, sleep disorder, weakness, etc. Its severity is also judged by violations of biochemical and hematological parameters. The determination of the severity of intoxication largely depends on the doctor's subjective assessment of the patient's condition. Since there are no simple, easily reproducible tests in the clinic, we recommend the use of a leukocyte index for a more accurate characterization of intoxication. The leukocyte intoxication index (LII) was introduced into use by Ya. Ya. Kalf-Kalif in 1941.