RU2144817C1 - Method of treatment of patient with acute intoxication - Google Patents

Abstract

FIELD: medicine, toxicology. SUBSTANCE: method is based on saturation of organs and tissues microcirculation with oxygen. For this purpose perfluorocarbon emulsion perfluoran is administrated parenterally twice, each other day at the dose 6-12 ml/kg after poisoning. Method ensures to enhance the effectiveness of treatment of toxic body damage by saturation of microcirculatory stream with oxygen and penetration into contracted and spasmodic vessels due to decreased emulsion particles. EFFECT: enhanced effectiveness of treatment. 3 tbl

Description

 The invention relates to medicine, namely to toxicology, and can be, in particular, used to treat acute poisoning.

From the practice of medicine, there is a known method for the treatment of acute poisoning of essentiale (Bulletin of Experimental Biology, Influence of hepatoprotectors on lipid metabolism in CCl ₄ hepatitis. A.I. Wegnerovsky, V.S. Chuchalin, O.V. Paul, A.S. Saratikov . N 4, 1987), consisting in the introduction of experimental animals ampoule solution of the essence after poisoning CCl ₄ . However, this method has significant drawbacks: it does not affect the rheological properties of blood, does not participate in the transport of oxygen to ischemic tissues, does not have a sorption, antitoxic and disaggregating effect, does not stop the occurrence of DIC, erythrocyte sludge, and requires long-term use (more than 4 times).

 There is also known a method for the treatment of acute poisoning, consisting in parenteral administration of reopoliglukin (E. A. Luzhnikov. Clinical toxicology. 1994, M.: Medicine), consisting in parenteral administration of reopoliglukin after poisoning of various etiologies. However, this method has the following disadvantages: the drug does not have a gas transport function, has contraindications for pathology, which is often encountered with poisoning by cauterizing fluids (bleeding), it is dangerous to cause complications - osmotic nephrosis - when used as a therapeutic agent for more than 3 days in a row, it is excreted by the kidneys , and therefore, its use is limited in oligoanuria.

The closest prototype to the proposed method is the use in acute poisoning of hyperbaric oxygenation (Kashuba EA The effect of hyperbaric oxygenation on the course of acute and subacute liver damage with carbon tetrachloride in the experiment. Voronezh State Medical Institute, abstract for the degree of candidate of medical sciences, 1976 g) consisting in the fact that the experimental animals after seeding 50% solution of carbon tetrachloride (CCl ₄₎ was subjected to oksigenobaroterapii barges D at a pressure of 3 atm, every other day for 15 days. On the 5th day (2 sessions), the authors noted only restoration of the mass of the hepatic parenchyma, and only on the 15th day (7 sessions) no zones of necrosis were determined, but hepatocyte dystrophy manifested, manifested by vacuolization of the cytoplasm, a change in its tinctorial properties, and nuclear pycnosis; it is indicated that dystrophic changes persist by the 30th day of the experiment (15 oxygenation sessions).

However, the known method has the following disadvantages:
- it does not allow saturating the blood vessels of the microvasculature without oxygen, increasing the delivery of oxygen to the ischemic tissues through collapsed, spasmodic, clogged vessels with red blood cells;
- has a direct dependence on the number of red blood cells in the bloodstream, in which the chemical dissolution of oxygen;
- does not improve blood rheology,
- does not stop the phenomenon of "sludge" of red blood cells, DIC syndrome;
- there is the possibility of complications associated with an overdose of oxygen;
- the duration of the procedure itself, the need for its repeated use to obtain a therapeutic effect (more than 5 times), thus a positive effect is achieved in a period of not less than 15 days;
- requires the use of expensive stationary, difficult to maintain equipment, specially trained personnel.

 The aim of the invention is to increase the effectiveness of the treatment of toxic lesions of the body by saturating the microvasculature with oxygen, increasing the useful area of capillary mass transfer, improving the rheological properties of blood by reducing its viscosity, reducing aggregation of platelets and red blood cells, increasing the resistance of cell membranes to chemical, mechanical and thermal factors activating detoxification function of the liver.

The goal is achieved in the invention by the fact that after poisoning CCl ₄ experimental animals are administered parenterally perfluorocarbon emulsion (Perftoran) twice every other day at a dose of 6-12 ml / kg

 The proposed method of administration was developed in an experiment on mice - 200 pcs. The perftoran emulsion was taken by the authors as a remedy for acute toxic lesions due to the fact that it has a number of unique properties and, primarily, is capable of transporting oxygen. ischemia and hypoxia of the internal organs plays an important role in the pathogenesis of acute poisoning; this property of the drug turned out to be promising in terms of the treatment of toxic lesions; the emulsion is also able to increase the resistance of cell membranes to the effects of damaging chemical, mechanical and thermal factors, has an antihemolytic effect, improves the rheological properties of blood as a result of lowering viscosity, reducing platelet and red blood cell aggregation. The method of emulsion administration - intraperitoneal - was chosen due to the small size of the experimental animals and the possibility of absorption of Perftoran from the abdominal cavity into the bloodstream, local effects on the abdominal organs, in particular, on the liver, which performs a detoxification function. The method of poisoning experimental animals was chosen due to the fact that the model of toxic damage with carbon tetrachloride is well known and accepted worldwide according to published data. Animal poisoning with hydrogen sulfide was chosen for the reasons that the Astrakhan region is part of the country's gas processing network and the industrial gas of the Astrakhan field is characterized by a high content of hydrogen sulfide, as well as the fact that up to now there is no effective treatment for acute hydrogen sulfide poisoning. The dose and frequency of administration of the drug Perftoran (6-12 ml / kg twice a day, after poisoning) was chosen experimentally - the animals were divided into 12 groups, which differed in dose and frequency of administration: for the administration of a smaller amount (less than 6 ml / kg) of the drug there was no significant effect from therapy, the most pronounced effect, both according to clinical (animal examination) and biochemical (determination of alanine and aspartic transaminases) data, but pathomorphological studies revealed a drug dose of 6 to 12 ml / kg, while aw It is noted that increasing the dose above 12 ml / kg does not lead to an improvement in all indicators, i.e. the dose of 12 ml / kg is a kind of saturation limit for the body with Perftoran, for which there is no further improvement in clinical, biochemical and pathomorphological parameters. Experimentally, the inefficiency of preliminary administration of the drug before poisoning was revealed.

 The proposed method allows: to saturate with oxygen not only the general blood flow, but also the microvasculature; increases oxygen delivery to ischemic tissues through collapsed and spasmodic vessels due to the smaller particle size of the emulsion compared to the red blood cell, the saturation of the bloodstream with oxygen does not depend on the number of red blood cells, because not chemical, but physical dissolution of this gas occurs; improves blood rheology; stops the phenomenon of "sludge" of red blood cells, DIC; the duration of the procedure itself does not exceed the duration of the usual intravenous injection of solutions, to obtain a therapeutic effect, a double administration of the emulsion is sufficient; the drug is excreted mainly through the lungs and a small amount through the gastrointestinal tract, thus it does not have a toxic effect on the kidneys and has no contraindications for toxic nephropathy, is not limited in use for bleeding; It does not require the use of expensive stationary, maintenance-free equipment and specially trained personnel, it is easily dosed, which allows you to individually select the dose of the drug and avoid side effects associated with an overdose of oxygen.

The essence of the invention is illustrated in table No. 1, where:
- the first line is the sequence of days of experience;
- the first column is a breakdown of animals into groups;
- "seed" - inhalation poisoning of animals CCl ₄ in a closed desiccator for 20 minutes;
- "emulsion administration" - intraperitoneal injection of Perftoran in a dose of 6 ml / kg;
- "the introduction of the emulsion in the maximum dose" - intraperitoneal injection of Perftoran in a dose of 14 ml / kg;
- "decapitation" - slaughtering of animals with subsequent extraction of internal organs and pathological examination;
- "group N 1" - a control group of animals exposed only to CCl ₄ followed by decapitation;
- "group N 2" - a control group of animals that received only injection P, followed by decapitation;
- "group N 13" - intact animals.

and table N 2, where:
- the first line is the sequence of days of experience,
- the first column is a breakdown of animals into groups,
- "seed" - inhalation poisoning of animals with hydrogen sulfide gas;
- "administration of an emulsion" - intraperitoneal injection of Perftoran in a dose of 12 ml / kg;
- "administration of the emulsion in the minimum dose" - intraperitoneal injection of Perftoran in a dose of 4 ml / kg;
- "administration of an emulsion in an average dose" - an intraperitoneal injection of Perftoran in a dose of 10 ml / kg;
- "decapitation" - slaughtering of animals with subsequent extraction of internal organs and pathological examination;
- "group I" - a control group of animals exposed only to hydrogen sulfide-containing gas with subsequent decapitation;
- "group II" - a control group of animals exposed only to hydrogen sulfide-containing gas, followed by delayed decapitation.

 The proposed method was successfully tested on 200 mice of the CBA line on the basis of the department of faculty therapy of the Astrakhan Medical Academy during 1994-95.

 Below are the results of testing.

Example N 1
Studies were performed on CBA mice (24 pcs.), Weighing 10-12 g, exposed to carbon tetrachloride. Seeding was carried out in a closed desiccator with a capacity of 4 liters, in the center of which 6 mice were placed on the grate, a wex with 0.05 ml of the preparation was placed on the bottom of the desiccator, which created a CCl ₄ concentration of 1.225 mg%. The exposure time of 20 min - 6 mice (group IV) and 20 min twice every other day - 6 mice (group VI) in the table. N 1. Injections of Perftoran were carried out intraperitoneally at a dose of 6 ml / kg twice with an interval of one day, the day after priming. The control was composed of intact mice injected with Perftoran (6 pcs.) And experimental animals exposed to CCl ₄ for 10 min without Perftoran (6 pcs.). 2 groups of mice were distinguished that differed by seed conditions (see above). Animals were kept in vivarium on a standard diet compiled according to the norms of the Ministry of Health of the Russian Federation. Before being tested, they were quarantined in a special room of the vivarium. Animals suspected of spontaneous pathology were rejected. Assessed: the appearance and general condition of the animal, the luster and smoothness of the coat, the presence of skin ulcerations and bites, the discharge from the nose, eyes, anus. In the experiments used control and experimental animals from the same batch. After the experiment, the animals were killed by decapitation and a pathological anatomical autopsy was performed with the extraction of the liver, heart, kidneys and lungs, followed by a description of their appearance and blood supply. For further research, part of the material was fixed in a 10% solution of neutral formalin. After fixation from organs by random sampling, pieces 5 × 5 × 3 mm in size were selected, which were dehydrated in alcohols of an ascending concentration of up to 100 ^° ethanol and embedded in paraffin for light microscopy. Blocks were cut on a domestic sled microtome, receiving sections 5-8 μm thick. The material tested for lipid content, after formalin fixation, was cut on a cryostat microtome into sections with a thickness of 10 μm. The obtained sections were stained with hematoxylinzosin, the Schick reaction was performed with amylase control according to the McManus method, to detect nucleic acids and nucleoproteins, the sections were stained with Brasho's methyl green-pyronine as modified by Kurnik, the total protein in the liver sections was determined by the strong green FCF according to Alferta and Geschwind. Neutral fats were stained in sections with Sudan III according to the Romeis method. Elective staining of collagen fibers was carried out by picrofuscin according to the Van Gieson method. Evaluation of the effectiveness of the histochemical reaction to ribonucleoproteins was carried out according to the method of G.A. Chekareva et al. (1982) in arbitrary units with gradation into four degrees: negative (0), low (1), moderate (2), high (3), very high (4). The results were evaluated by methods of medical statistics (G. G. Avtandilov, 1973, 1974) with an assessment of the reliability of signs according to the Studen criterion. In case of CCl ₄ poisoning - control with seed - animals developed severe liver damage: many periportal and bridge-like portal-portal necrosis with a weak inflammatory response, in some animals there was a vacuole or granular hepatocyte dystrophy, vascular congestion; heart - granular and hyaline droplet degeneration of cardiomyocytes, focal necrosis, pronounced circulatory disorders in the vessels of the type of "sludge" phenomenon and DIC; kidneys - the phenomena of granular, hyaline droplet, sometimes vacuole dystrophy of the convoluted Cayalis epithelium and the proximal nephron, circulatory disorder in the microcirculation system (glomerular and parenchymal capillaries). In the control group with the introduction of perftoran, no changes in the organs were detected, the liver contains diffuse P inclusions in the cytoplasm of hepatocytes. In group IV, a moderate to severe picture of productive aggressive hepatitis with zonal necrosis is expressed in the liver against a background of moderate hyaline droplet degeneration of the hepatocytes of the periportal lobules and single hepatocytes of the other sections. In hepatocytes of the central lobes of inclusion P. In the kidneys, focal vacuole dystrophy of the tubular epithelium and are expressed in varying degrees of circulatory disorders. In the heart, focal granular and hyaline droplet dystrophy, circulatory disorders are not clearly expressed. Group VI revealed the preservation of the liver structure, single hepatocytes along the edge of the portal tracts in a state of hyaline droplet dystrophy. Almost all hepatocytes contain vacuoles P, the vessels are full-blooded. In the kidneys and heart, the structure is preserved.

Thus, on the obtained model of the toxic damage to the CCl ₄ organism, the therapeutic effect of Perftoran at a dose of 6 ml / kg is observed, which is expressed in a decrease in the number, and in group IX, in the disappearance of necrosis, a decrease in the intensity of degenerative phenomena, circulatory disorders in the liver, and normalization structures of the kidneys and heart, a more significant improvement in the morphological picture despite a twofold inoculation is observed in group IX, which can be explained by a delayed postmortem autopsy and longer Stimulation of the drug on the body.

An extract from the medical history of patient S., born in 1969, is given. with poisoning with a chlorine-containing compound, which was admitted to the toxicological department of the medical unit of the AGPK 1.01.96 with a diagnosis of severe poisoning with a chloroform severe severity, severe toxic hepatonephropathy, acute liver and kidney failure. In the clinical picture, the following symptoms dominated: fever up to 39 - 40 ^o C, jaundice, diffuse abdominal pain, bloating, nausea, weakness, hemorrhagic manifestations in the form of rashes on the skin and melena. Along with traditional complex therapy, the patient was given an intravenous drip of Perftoran emulsion on the 6th day after poisoning (6.01.96) in an amount of 400 ml, simultaneously with the inhalation of a moistened oxygen-air mixture. Improvement of health occurred the day after the infusion of the drug and was manifested by a decrease in weakness, a decrease in body temperature to normal, a decrease in pain and flatulence, relief of headache, and a decrease in the intensity of jaundice and hemorrhagic syndrome. The dynamics of some indicators of laboratory research are presented in the form of a table. 3, where the most obvious positive changes in the cholestatic syndrome are a decrease in bilirubin and its fractions from 224.0 mM / L to normal within 19 days, and in the first 3 days it decreased by more than 2 times; cytolytic syndrome - a decrease in ALT from 3.8 μM / h x L to normal within 6 days, AST from 2.7 μM / h x L to normal within 19 days:
Thus, analyzing the case history of patient C., one can talk about the high effectiveness of Perftoran in the treatment of toxic hepatopathy, which is expressed in the rapid relief of the clinical manifestations of toxic liver damage and the normalization of laboratory data - indicators of cholestatic and cytolytic syndromes.

Example N 2
The studies were performed on CBA mice (24 pcs.), Weighing 10-12 g, exposed to hydrogen sulfide-containing gas. The seed was produced in a special seed chamber produced by the Moscow Institute of Occupational Diseases and Occupational Health. Erisman 200 liters. For research, natural gas of the Astrakhan field was used. The experiments were conducted on intact animals with gas mixtures of air with hydrogen sulfide-containing gas at a concentration of 300 mg / m ³ for hydrogen sulfide, which is the most aggressive component of natural gas in the Astrakhan field, the exposure time is 1 hour. The selection of natural gas was carried out in containers with samplers of the PGO-50 type according to GOST 149-69 from the metering unit of the Y-171 installation at the Astrakhan gas processing plant. The composition of gas samples was determined in the central factory laboratory by gas chromatographic analysis on a GC - 121 VL chromatograph. In the experiments, industrial gas of the Astrakhan field of the following composition was used (data are given in vol.%):
Methane - 57.23 ± 1.24
Ethane - 2.26 ± 0.17
Propane - 0.94 ± 0.06
Iso-butane - 0.28 ± 0.04
Carbon dioxide - 13.78 ± 1.21
Nitrogen - 0.52 ± 0.02
Hydrogen sulfide - 24.03 ± 1.33
The determination of the concentration of hydrogen sulfide in the air-gas mixtures used was carried out in accordance with GOST 22387.2-83 (STS 7V 3763-82). The method is based on the binding of hydrogen sulfide from gases with solutions of cadmium acetic acid or chloride, followed by iodometric titration. Indicator tubes were also used to determine hydrogen sulfide.

 Perftoran injections were administered intraperitoneally at a dose of 12 ml / kg. The control was composed of intact mice injected with Perftoran and experimental animals exposed to hydrogen sulfide-containing gas without Perftoran. 2 groups (IV and VI) of mice were distinguished, differing by exposure conditions, table. N 2.

 After the experiment, the animals were killed by decapitation and a postmortem autopsy was performed followed by histological examination of the liver, heart, kidneys and lungs, blood was taken to study the cytolytic enzymes alanine and aspartic transaminases (Reitman, Frankel, 1957). Subsequent processing of sections from the extracted organs was carried out according to the method described in example No. 1.

 Significant changes in organs were revealed in the control group with a seed during a post-mortem examination, in the lungs - most of the lung tissue was in a state of dis- and atelectasis with vascular permeability disturbances, and in places massive intraalveolar hamorrhages with accumulations of gamideiderophages. Large and medium bronchi with severe hyaline droplet degeneration and desquamation of the epithelium. Initial effects of acute endobronchitis and bronchiolitis. In the surrounding lung tissue, the picture of the beginning focal purulent-desquamative pneumonia. In the liver - severe discompletion of the hepatic lobules. Diffuse hyaline droplet degeneration, focal / group / necrosis of hepatocytes is expressed. Moreover, in hepatocytes, the manifestations of discariosis / change in the shape and size of the nuclei, blocky condensation of chromatin, fenestration /, and around necrosis hyperplasia of stellate endotheliocytes are expressed. In the stroma of the portal tracts, edema, venous congestion, diffuse granulocyte infiltration, and fibroblast proliferation. In the kidneys there is a mild focal granular and hyaline droplet dystrophy of the tubule epithelium of the proximal part of the nephron. Heart - moderate hyaline droplet degeneration of muscle fibers, circulatory disturbance in the capillaries according to the "type" of erythrocyte sludge. An increase in cytolytic enzymes was noted - ALT to 2.34 mmol / L, AST to 2.21 mmol / L. In the control group with the introduction of perftoran - control N 2 - no changes in organs were detected, the liver contains diffuse P inclusions in the cytoplasm of hepatocytes. The pathomorphological picture of the internal organs of animals of group IV most clearly shows the therapeutic effect of P. - in most animals the tissue in the lungs is airy, there are small areas of distelectases. Small bronchi in their area with the phenomena of bronchospasm, and in the lumen of the alveoli edematous masses. In the liver - slight discompletion of lobules, hepatocytes are not changed, small vacuoles P in the Kupffer cells; in the heart, the structure of normal muscle fibers; kidneys - the structure is not changed. A decrease in alanine and aspartic transaminases was noted - 1.75 and 1.7 mM / L, respectively. The XI group also showed an improvement in the pathomorphological picture compared with the control, although to a lesser extent than in the IV group: lungs - the main tissue of the lung tissue is airy, without signs of pathology, but about 1/3 of the tissue is in the state of distelectases with symptoms of bronchospasm and disturbance vascular permeability; liver - against the background of discompletion of lobules, a picture of diffuse granular and hyaline droplet hepatocyte dystrophy with the phenomena of discariosis; kidneys - granular and hyaline droplet dystrophy of the tubular epithelium; heart - focal hyaline droplet degeneration of muscle fibers. Cytolytic enzymes also tend to decrease ALT - 1.7 mM / L, AST - 1.7 mM / L.

 Thus, when treating experimental animals with Perftoran in a dose of 12 ml / kg after inhalation poisoning with hydrogen sulfide-containing gas, a distinct therapeutic effect is observed, which is expressed in stopping the processes of purulent-desquamative pneumonia, dystrophic and inflammatory phenomena in the bronchi, impaired vascular permeability in the lung tissue, therapeutic effect it is noted in the liver tissue, kidneys and heart: the disappearance of the phenomena of dystrophy, microcirculation disorders, necrosis of hepatocytes, the phenomena of hepatic discariosis cells, a decrease in the level of cytolytic enzymes is also observed, while the greatest therapeutic effect is observed in group IV, which indicates its direct dependence on the intensity of poisoning (in group VI, the seed is twofold).

Example N 3
The studies were performed on CBA mice (6 pcs.), Weighing 10-12 g, exposed to hydrogen sulfide-containing gas. The seed technique is described in Example No. 2. Perftoran injections were administered intraperitoneally at a dose of 10 ml / kg (group III / 3) of the table. N 2. After the experiment, the animals were killed by decapitapia and a postmortem autopsy was performed followed by histological examination of the liver, heart, kidneys and lungs, blood was taken to study cytolytic enzymes - alanine and aspartic transaminases (Reitman, Frankel, 1957). Subsequent processing of sections from the extracted organs was carried out according to the method described in example No. 1. When pathological examination in the lungs - most of the tissue is airy and full-blooded. The capillaries of the interalveolar septa of moderate blood filling, the bronchi are not changed, in some areas the picture of bronchospasm with the phenomena of serous endobronchitis. In the zone of these changes, focal distelectases with a picture of impaired vascular permeability, single and groups of perfluorinated macrophages are found in some alveoli. In the liver, the structure of the lobules is preserved, there is a mildly expressed granular dystrophy of hepatocytes of the third zone of acini. In the kidneys - a picture of a normal structure. In the heart, in some animals, the norm is normal, in others, there is a mild granular dystrophy of muscle fibers. The level of cytolytic enzymes was high, but still less than in the control with the seed hydrogen sulfide-containing gas: ALT - 2.0 mmol / l, AST - 1.8 mmol / l.

 Thus, the therapeutic effect of Perftoran at a dose of 10 ml / kg is observed in case of toxic damage to the body by a hydrogen sulfide-containing gas, which consists in reducing the processes of dystrophy and disturbances in the microvasculature, but inflammatory phenomena persist in some organs (lungs); the level of cytolytic enzymes decreases, although it is higher than the dose of Perftoran 12 ml / kg, which indicates an insufficient dose of Perftoran 10 ml / kg in the treatment of toxic damage to hydrogen sulfide-containing gas.

Example N 4
Studies were performed on CBA mice (6 pcs.), Weighing 10-12 g, exposed to hydrogen sulfide-containing gas. The seed technique is described in example No. 2. Perftoran injections were carried out intraperitoneally at a dose of 4 ml / kg (group III / 2) table. N 2. After the experiment, the animals were killed by decapitation and postmortem followed by histological examination of the liver, heart, kidneys and lungs, blood was taken to study cytolytic enzymes - alanine and aspartic transaminases (Reitman, Frankel, 1957). Subsequent processing of sections from the extracted organs was carried out according to the method described in example No. 1. When pathological examination of sections of the organs revealed that most of the lung tissue in the state of distelectases. There is also a picture of impaired vascular permeability. In large and medium bronchi, the phenomena of hyaline droplet degeneration and desquamation of the epithelium. In small ones - a picture of bronchospasm with the phenomena of serous endobronchitis and small focal pneumonia. In the liver - discompletion of lobules and hyaline droplet diffuse dystrophy of hepatocytes with a picture of discariosis. In the kidneys - severe granular dystrophy of the epithelium of the convoluted tubules, plethora of capillaries, glomeruli are not changed. In the heart - focal hyaline droplet degeneration of muscle fibers. Transaminase uptake was recorded: ALT - 1.75 mM / L, AST - 1.95 mM / L.

 Thus, the therapeutic dose of Perftoran 4 ml / kg in case of toxic damage to the body with hydrogen sulfide-containing gas is insufficient, because almost the same changes remain in the organs as the control with the seed.

Example N 5
Studies were performed on CBA mice (6 pcs), weighing 10-12 g, exposed to carbon tetrachloride. The seed technique is described in Example No. 1. Perftoran injections were administered intraperitoneally at a dose of 14 ml / kg twice with an interval of one day, after the seed (group IV) table. N 1. After the experiment, the animals were killed by decapitation and a postmortem autopsy was performed with the extraction of the liver, heart, and kidneys. Subsequent processing of sections from the extracted organs was carried out according to the method described in Example No. 1. During the pathoanatomical study of the sections of the organs, it was revealed that the structure was preserved in the liver, in the periportal spaces along the edge of the border plate there were single hepatocytes with the phenomena of hyaline droplet dystrophy and a small polymorphic cell infiltration, isolated single perft macrophages, hepatocytes in the center of the lobules contain Perftoran particles, the vessels are full-blooded; kidneys and heart of usual structure.

 Thus, the dose of Perftoran of 14 ml / kg does not give a further improvement in the pathoanatomical picture of the toxic damage to the body, the picture corresponds to that in group VI (Table N 1) and in Group IV (Table N 2), at a dose of Perftoran 6-12 ml / kg A dose of Perftoran of 12 ml / kg can be considered the saturation limit of the body with a drug, exceeding which does not further improve the toxic damage indicators.

 The proposed method achieves an increase in the effectiveness of treatment. Perftoran allows to saturate with oxygen not only the general blood flow, but also the microvasculature; increases oxygen return to ischemic tissues, which reaches over 90%, easily penetrates into collapsed, spasmodic and impenetrable vessels due to the smaller particle size of the emulsion compared to an erythrocyte, which increases the useful area of capillary mass transfer, provides oxygen to tissue areas with a depleted vascular network and poor blood circulation, while the saturation of the bloodstream with oxygen does not depend on the number of red blood cells, because not chemical, but physical dissolution of this gas occurs, which does not reduce its effectiveness in case of anemia of various origins; reduces the level of lactic acid in the blood more pronounced than reopoliglyukin; improves the rheological properties of blood by reducing viscosity, reducing platelet and erythrocyte aggregation, increases the negative charge of red blood cells, which creates an electric breakdown between red blood cells and capillary walls; stops the phenomenon of "sludge" of red blood cells, DIC; increases the resistance of cell membranes to the effects of damaging chemical, mechanical and thermal factors due to the formation of a "viscous" barrier on the surface of the red blood cell, preventing the penetration of hemolytic; changes the functional properties of red blood cells, increasing their resistance to mechanical trauma, to hypo- and hyperosmia, to the action of detergents and ionophores, increases their thermostable resistance; reduces the depth of acidosis; activates detoxification function of the liver; the duration of the procedure itself does not exceed the duration of the usual intravenous injection of solutions, to obtain a therapeutic effect, a double administration of the emulsion is sufficient; the drug is excreted mainly through the lungs and a small amount through the gastrointestinal tract, thus it does not have a toxic effect on the kidneys and has no contraindications for toxic nephropathy, is not limited in use for bleeding; It does not require the use of expensive stationary, maintenance-free equipment and specially trained personnel, it is easily dosed, which allows you to individually select the dose of the drug and avoid side effects associated with an overdose of oxygen.

 The proposed method can be recommended in the practice of toxicological departments of the health system.

Claims (1)

 A method of treating acute poisoning, which consists in saturating the microcirculation of organs and tissues with oxygen, characterized in that after poisoning, perfluorocarbon emulsion is administered intravenously - perfluorane twice, every other day at a dose of 6 - 12 ml / kg.

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