RU1808329C - Polyionic disintoxicating solution for separative processes on semipermeable diaphragms - Google Patents

Abstract

The invention relates to medicine, namely to surgery, and can be used in those cases when it is necessary to carry out separation processes on semipermeable membranes, in particular in the treatment of peritonitis. The purpose of the invention is the implementation of effective detoxification and correction of electrolyte disturbances in the body. SUMMARY OF THE INVENTION: a polionic detoxification solution contains calcium chloride, potassium chloride, sodium chloride, magnesium chloride, sodium acetate, polyvinylpyrrolidone, chlorhexedine bigluconate, distilled water in certain proportions of components.

Description

The invention relates to medicine, namely to surgery, and can be used in those cases when it is necessary to carry out separation processes on semipermeable membranes, in particular in the treatment of peritonitis.

The purpose of the invention is to provide dialysis. a solution that allows for the effective correction of electrolyte disturbances in the patient's body, by selecting the optimal ratios of the main electrolytes, which have pronounced detoxification and antimicrobial properties, and are suitable for filling functionally active drains that are used to treat peritonitis.

The goal is achieved in that, due to the high osmolarity of the solution, active elimination of toxic objects from the abdominal cavity through the pores of the semipermeable membrane into the solution, which is in the FAD, where they are inactivated, is active.

by the formation of persistent non-toxic compounds. The electrolytes contained in the solution and effective antibacterial drugs support homeostasis in the patient’s body and provide a long-lasting maximum effective antibacterial effect in the lesion.

Example 1. As a polyionic Analyzing detoxification solution Polydiades, a solution of the following composition is proposed, g / l:

NaCl-5.9; KCI-0.25; CaCl2 0.15; MgCl2 -0.10;

(СНзООМа + ЗНаО) - 5.0, polyvinylpyrrolidone-150, chlorhexedine bigluconate - 0.2,

For 1 liter of pyrogen-free (distilled) water in grams.

Polyvinylpyrrolidone is loaded into the apparatus, previously filled with non-pyrogenic water in an amount of 30% of the calculated one and at a temperature of 30 ° C. Then,

(L

WITH

with

about

00

from

when the stirrer is on, a set of salts is loaded. The volume of respirogenic water is adjusted to the calculated one, followed by the addition of the antiseptic chlorhexedin.a bigluconet. The solution is mixed until all components are dissolved, filtered through pre-filters and sterilizing filters, bottled, which are sealed with stoppers, aluminum caps and sterilized.

PRI me R 2. Dialysis solution contains, g / l:

NaCI -8.0

COP -0.30

CaC12 - 0.30

MgCl2-0.20,

(CH2COONa + 3H20) -6.0

polyvinylpyrrolidone - 200

chlorhexedine per bigluconate - 0.21 per 1 liter of pyrogen-free (distilled) water in grams. The solution was prepared as in Example 1, only the chlorhexedine bigluconate antiseptic was added immediately before use.

The proposed dialysis solution is a clear yellow liquid, slightly opalescent. The osmolarity of the proposed dialyzed solution varies between 560-700 mmol / L and does not change during long-term storage for 2 years. The osmotic pressure of the extracellular fluid (plasma, peritoneal exudate, lymph) is 290-310 mmol / l, therefore, when performing peritoneal dialysis, as well as the use of FAD using the proposed solution with an osmolarity of 560-700 mmol / l, completely undesirable the effect of back diffusion of the solution from the lumen of the FAD and the abdominal cavity into the bloodstream, which is observed when using solutions with osmolarity up to 370 mmol / L. By replacing glucose in a new dialysis solution with polyvinyl pyrrolidone, the risk of hyperglycemia in patients with diabetes mellitus and the induction of the active production of large amounts of triglycerides in patients with no diabetes is eliminated.

This eliminates the risk of developing hyperhydria and increased intoxication, both when using FAD and during peritoneal dialysis. The use of polyvinylpyrrolidone in a solution in a .5-20% concentration (150-200 grams per 1 l) ensures the preservation of high osmolarity to the dialysis solution for 24 hours, which is what you define

optimal solution change mode in FAD. Such a long-term high osmolarity of the solution used. Provides a very effective elimination

toxic objects from the abdominal cavity and the bloodstream not only due to ultrafiltration processes, but also due to the convention that takes place during this process, as well as to the concentration gradient. The total detoxification effect of the use of the proposed solution in FAD will be many times greater than that of the previously known dialysing solutions, where to obtain a similar effect, it will be necessary to use a different regime of peritoneal dialysis with a consumption of a large quantity of dialysis solution up to 15-20 l A high detoxification effect in the proposed dialysis solution is achieved through the use of polyvinylpyrrolidone with a molecular weight of 12,000 + 2,700. The structure of its molecule provides the possibility of bonds with many biological

5 active substances, including those with exo- and endogenous toxins with the formation of persistent non-toxic complexes, and thereby prevents their pathological effects on the body. Lack of glucose

0 in the proposed dialysis solution allows sterilizing and storing it without fear of the caramelization processes that always occur when using dialysis solutions, where glucose is mixed with salts. Stabilization of the pH of the solution is achieved by the inclusion of sodium acetate, which prevents the precipitation of calcium and magnesium salts with precipitation.

0 In addition, entering the body through a semipermeable membrane from FAD or the peritoneum during peritoneal dialysis, sodium acetate undergoes an exotic conversion to bicarbonate,

5, the acid-base state in the patient is most regulated. The balance and the optimal range of fluctuations in the content of basic electrolytes in the proposed dialyzed solution provide the necessary correction of all electrolyte disturbances in the organism in a patient with purulent peritonitis. The content of calcium salts within the specified limits eliminates the loss of

5 fibrin in the abdominal cavity around the FAD drainage. The content of chlorhexedine bigluconate in the solution, calculated as 0.2-0.21 grams per 1 liter of 1.5-20% PVP of pyrogen-free (distilled) water, provides the solution with high antibacterial

properties that do not change during sterilization and long-term storage.

Examples of clinical use of the Polyionic detoxification dialysis solution Polydiodes.

Patient V. Age 35 l. gender husband. Case histories N 838. Received March 3, 1989. Discharged March 28, 1989. Diagnosis: blunt trauma to the abdomen with rupture of the small intestine. Diffuse purulent peritonitis, mild alcoholic coloration.

March 4, 1989 surgery with / median laparotomy, suturing of the wound of the small intestine, sanitation with the Geyser apparatus, drainage of the abdominal cavity with 4 membrane drains through contrapertures in both iliac regions. The initial amount of dialysis solution in membrane drains is 120 ml.

And March 1989, the General anal blood: leukocytes - 12.2 -109 g / l, HB-150 g / l - 150 g / l, er-ty4.62.

Total anal urine: - 1028, protein - 100 mg / ml, MSM blood - 0.298 conventional units

On March 5, the condition is severe, along the membrane. functional-active drains (FADO removed 240 ml of dialysate. March 5, MSM blood - 0.340 conventional units, biochemical blood test: total bilirubin - 28, ohm-mol, urea - 5.5 mmol / l, ca - 1.9 mmol / l, total protein - 66 g / l. 120 ml of polydiadese was introduced into the FAD Biochemical analog dialysate: total bilirubin - 4.0 μmol / l, CA - 1.3 mmol / l. urea - 4 , 8 mmol / l; OS mol rnrst - 305 mmol / l. MSM-0.692 conventional units.

March 6: 238 ml of dialysate was removed via membrane drains, 120 ml of 15% polydiadhesis was introduced. Biochemical channel. dialysate: commonly. bilirubin - 8.0 μmol / l, 1.5 mmol / l, urea - 5.5 mmol / l, MSM - 0.533 conventional units March 7: drainage removed

210 ml of dialysate, drainage removed. Inoculation with FAD for microbial growth did not give. Biochemical channel. dialysate commonly bilirubin - 8.0 μmol / l, CA - 1.6 mmol / l, urea - 5.25 mmol / l, MSM-0.285 conventional units

MSM blood - MSM - 0.390 - conventional units March 13th: biochemical channel. blood - commonly. protein - 66 g / l, urea - 4.5 mmol / l, total bilirubin - 8.78 mmol / l, potassium - 3.2 0 mmol / l, sodium - 135 mmol / l, chlorides - 120 mmol / l, calcium - 2.1 mmol / l,

Claims (1)

Total blood count: HB - 126 g / l, white blood cells - 8.4 -109 g / l, Eosin-1, pal-6, segm-67, lymphocytes-17 monocytes-9, ESR-55 hours. March 5: er-you - 3.57 1012 g / l, HB - 140 g / l, leukocytes - 3.5 109 g / l, eosinophils - 2, p-6, segment -65, lymphocytes-19, monocytes - 8, ESR-43 mm / hour. March 21: HB - 122 g / l, white blood cells-6.9 109 g / l, ESR-39 mm.h. March 27 MSM - blood - 0.280 conventional units On March 28, he was discharged in satisfactory condition. SUMMARY OF THE INVENTION A polyionic detoxification solution for separation processes on semipermeable membranes containing calcium chloride, potassium chloride, sodium chloride, magnesium chloride, sodium acetate, distilled water, characterized in that, in order to carry out effective detoxification, it additionally contains polyvinylpyrrolidone and chlororgene the following ratio of components, g / l: Potassium chloride 0.25-0.30 Sodium chloride 5.9-8.0 Calcium chloride 0.15-0.30; Magnesium chloride 0.10-0.20; Sodium acetate 5.0-6.0; Polyvinylpyrrolidone 150-200: Chlorhexedine bigluconate 0.2-0.21; Distilled water Else. 0 5 0 5 0