RU2112521C1 - Method of thermal burn treatment - Google Patents

Abstract

FIELD: medicine, therapy. SUBSTANCE: method involves an intravenous administration of 3-% solution of protein fraction KOH-IV₁ from donors serum blood to patient in 1, 5 and 24 h after traumatic damage at the dose 300-400 mg/kg body mass per single injection. Method can be used in infusion-transfusion therapy at severe traumas and extremal states of organism. EFFECT: enhanced effectiveness of thermal burns therapy. 1 tbl

Description

 The invention relates to medicine, namely to infusion-transfusion therapy for severe injuries and extreme conditions of the body.

 Known methods of detoxification therapy for burns, thermal lesions, consisting in replenishing the pool of functionally active body proteins by intravenous administration of native or dry isogenic plasma preparations. The use of these methods in the clinic of thermal burns gives a noticeable therapeutic effect, which is achieved by transfusion of relatively large amounts of plasma and albumin [1]. The disadvantage of these methods is the possibility of transmission of serum hepatitis and the development of lysis of red blood cells and hemoglobinuria. A known method of treating thermal burns by the introduction of albumin [2,3].

 The disadvantage of this method (the closest analogue to the proposed method) is the need for daily long-term administration of albumin preparations and its combination with the introduction of a physiological solution of sodium chloride under the skin, without which it is not possible to achieve a longer life span.

 Obviously, medical care at the initial stages of evacuation before the arrival of victims in specialized medical institutions should be based on a minimum number of technically simple and highly effective therapeutic measures [4].

 The known method of detoxification therapy using multiple intravenous infusions of albumin combined with subcutaneous administration of physiological saline cannot provide an effective decrease in the biological activity of toxic toxic medium-molecular peptides, which are known to accumulate in the blood of patients with severe injuries, myocardial infarction, uremia, and liver damage and a number of other conditions of the body, with a burn disease [5]. It is also known that pharmacopoeial preparations of a 10% albumin solution effectively bind medium molecular peptides of the blood only after pretreatment of the protein preparation, for example, with sorbents, which makes it possible to remove compounds of various chemical nature that dramatically decrease the affinity of albumin for medium molecular peptides to the binding centers of albumin [6]. The known method includes the introduction of the usual preparation of 10% albumin, which has a low binding ability with respect to medium molecular weight peptides.

 Thus, the known method is relatively complex and does not provide effective detoxification of the body according to a significant pathogenetic factor - the toxic effect of medium molecular peptides.

In order to increase the therapeutic effectiveness of the method by replenishing the fund of functionally active proteins of the body, it is proposed that, with thermal burns, three times intravenous administration of a 3% solution of the protein fraction Con-IV ₁ be carried out at a dose of 300-400 mg / kg body weight for each administration, 1, 5 and 24 hours after injury.

 The method is as follows.

1 h after severe thermal injury, a 3% solution of the Con-IV ₁ protein fraction obtained from the blood of donors is administered intravenously at a dose of 300-400 mg / kg body weight. The procedure is repeated twice after 5 and 24 hours after injury.

As established by the authors, the dose of the Con-IV fraction ₁ 300-400 mg / kg provides a replenishment of the pool of functionally active proteins in an amount corresponding to the normal content of this fraction in the blood plasma. The total dose of the introduction of the protein fraction during the day after the injury is 0.9-1.2 g / kg body weight, which fits into the existing recommendations for the treatment of calcined by the introduction of protein preparations of blood in a dose of about 1.0 g protein per 1 kg of body weight per day [7].

Example. The experiment was conducted on 56 mice-hybrids F / CBA x C ₅₇ VI /. A deep burn of IIIb-IV degree of 10-12% of the body surface of the animal was applied under ether rush anesthesia using a special unit for dosed burns, the heat source of which was incandescent lamps - electric, quartz halogen KG 220 V, 1000 watts. The animals of the experimental group, which included 28 mice, were injected intravenously with a 3% solution of the protein fraction of Con-IV in a volume of 0.2 ml according to the proposed method. 28 mice of the control group according to the same scheme - 1, 5 and 24 hours after the injury, 0.2 ml of physiological sodium chloride solution was intravenously administered. The results of observation of animals of both groups during the 30 days of the experiment are presented in the table.

 As can be seen from the table, the proposed method ensures the survival of 28% of the animals of the experimental group with the complete death of the animals of the control group, which occurs on the second day after the injury, while at the same time about 50% of the mice of the experimental group remain alive.

 When comparing the results with the results obtained when implementing the known method (prototype), the advantages of the proposed method are obvious. Thus, the administration of albumin to animals increased the average life expectancy of experimental animals by 1.8 times (21.9 ± 2.9 days compared to 12.6 ± 2.4 days in the control), whereas when implementing the proposed method, the average life expectancy of animals with severe burns it increases by 7.2 times (10.14 ± 2.43 days compared with 1.46 ± 2.49 days in the control, p 0.001). In addition, the proposed method increases the overall survival of animals, which is not achieved when using the prototype. So, with severe thermal injury, 28.5% of the animals survived. Thus, the proposed method has a greater therapeutic activity in comparison with the prototype method.

Sources of information
1. Rudovsky V. et al. Theory and practice of treating burns. - M., 1980.

 2. Lutz W. Chemical composition and rate of passage across semipermeable membranes of basic peptides isolated from peritoneal dialisis fluid from patients with chrohic renal failure // Acta Med.Pol.-1976.-Vol.17, N 2.-P. 137-147.

 3. Nikolaychik VV Molecular mechanisms of development of endogenous intoxication and improvement of detoxification pathways: Abstract. dis. Dr. med. sciences. - M., 1984. - c. 43.

 4. Guidelines for the treatment of burned at the stages of medical evacuation / Ed. V.K.Sologuba. - M., 1979.

 5. Tupikova Z.A. Medium molecular uremic toxins, review // Questions of medical chemistry. - 1983, N 1, pp. 2-10.

 6. Autosvid.SSSR N 1037451, Method for the production of plasma proteins.

 7. Vikriev B.S. Burns. - M., 1983.

Claims (1)

A method of treating thermal burns by intravenous administration of a donor serum protein fraction, characterized in that 1.5 and 24 hours after the injury, a 3% solution of the protein fraction KOH-IV ₁ is introduced at a dose of 300-400 mg / kg body weight for each introduction.

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