RU2195335C2 - Method for internal electrophoresis of potassium by direct current - Google Patents

Abstract

FIELD: medicine, cardiology, can be used for internal electrophoresis of potassium. SUBSTANCE: a solution of potassium chloride is introduced by electrophoresis by a low 40-80-μA. current. The positively-charged needle electrode is introduced in the region of internal infusion of potassium chloride. The negatively-charged plate electrode is fastened on the patient's chest in the heart projection. EFFECT: enhanced efficiency of internal electrophoresis of potassium. 2 ex

Description

 The invention relates to the field of clinical medicine, namely to cardiology and the administration of drugs by electrophoresis.

There is a method of treating purulent wounds by exposing the wound to a solution of potassium permanganate, while the wound is exposed to a diadynamic current of positive polarity of 4-12 mA. The method is as follows: after the toilet of the wound, the affected limb is immersed in a glass (earthenware, porcelain) bath with a solution of 0.1% potassium permanganate at a temperature of 36-38 ^o C. The procedure is carried out by the device SNII-1. A plate lead electrode with a positive pole is lowered into the solution, and a electrode with a negative pole is placed on the forearm and strengthened with a rubber bandage. A diadynamic current modulated with short periods of 10 minutes per procedure is used. The current strength is 4-12 mA, the procedure is carried out daily. The course of treatment is 2-10 procedures (1).

 The disadvantage of this method is the impossibility of its use in the treatment of cardiological patients to increase the potassium content in cardiomyocytes, in addition, the use of diadynamic current when exposed to the heart can give an arrhythmogenic effect.

The closest adopted for the prototype is the method of using galvanization by a transcardial technique in the treatment of the acute stage of myocardial infarction. Transcardial galvanization procedures are carried out for 60 minutes with an interval of 12 hours (a total of 6-7 procedures) with a current strength of 4 mA, a current density of 0.02 mA / cm ² . The electrodes are placed on the patient’s body as follows: positive - in the precardial zone between the second and fifth intercostal space, 1-1.5 centimeters to the left of the parasternal line, negative - in the interscapular space from the sixth cervical to the second or third thoracic vertebrae. The area of both electrodes is the same and is 200 cm ² . The source of direct electric current is the apparatus "Potok - 1" (2, 3).

 This method eliminates the supply of potassium directly to the heart.

 The aim of our invention is to reduce the treatment time for electrolyte myocardial disorders, which are manifested by pathological changes on the electrocardiogram (ECG) due to the direct transportation of potassium ions to the heart muscle and the supply of electric current through the bloodstream.

 This goal is achieved by the fact that a needle-shaped positively charged electrode is introduced into the route for intravenous administration of a potassium chloride solution, and a negative plate electrode is mounted on the patient’s chest in the projection of the heart, in the Zakharyin-Ged zone, and an intravenous potassium electrophoresis is performed by a small constant electric current about 40-80 μA, the duration of the procedure is about 1 hour.

 The proposed method allows for hypokalemia, a direct influx of potassium ions through the venous channel to the heart muscle, which is reflected in the corresponding positive changes in the patient's ECG and is expressed in an increase and sharpening of the T wave during an hourly intravenous electrophoresis. In a number of cases, immediately after the procedure, in patients the processes of depolarization and conduction improve, and in patients with arrhythmias, the normal minus rhythm is restored. During the same time, in the control group, which included patients who underwent only intravenous infusion of potassium chloride solution according to the same scheme, in the same doses, but without intravenous electrophoresis, no changes on the ECG occurred.

 The proposed method is as follows. To carry out the procedures, use the Luch electrical stimulator. The "treatment mode" switch is set to the "post" position, the "number of cycles" switch is set to the "infinity" position, the "diagnostics" switch is set to the (+) position. A negative electrode, which is a 10 x 10 cm copper plate, is applied with a band-aid on the patient’s chest in the projection of the heart, in the Zakharyin-Ged zone, and gauze moistened with saline is placed under it. A positive electrode, made in the form of a sterile needle, is inserted into the route for infusion therapy. A 2% potassium chloride solution in a 5% glucose solution is fed into this route through a microdoser at a dose of 3 milliequivalents per liter per day under the control of the potassium content in the plasma. A small constant electric current of about 40-80 μA is applied to the electrodes. The duration of the procedure is 1 hour. The method was applied in cynical conditions in postoperative cardiac surgery patients. In a group of 50 people, 25 patients underwent an hour-long procedure of intravenous electrophoresis of potassium chloride. In these patients, the processes of depolarization and conduction improved; in patients with arrhythmia, in some cases, the normal sinus rhythm was restored. To another group of patients of 25 people, only intravenous infusion of potassium chloride solution was carried out according to the same scheme, in the same doses, but without intravenous electrophoresis. In these patients, obvious positive changes after an hour on the electrocardiogram was not observed.

 Example 1

 Patient S., 57 years old, condition after aortic valve replacement surgery, initial serum potassium 3.0 meq / l. Before the procedure: sinus rhythm 95 per minute. Blockade of the right bundle branch block. Left ventricular hypertrophy. An hour after the start of treatment: sinus rhythm of 95 per minute, intraventricular conduction improved, the blockade of the right bundle branch block disappeared, the amplitude of the T wave is within normal limits, i.e. positive dynamics are noted.

 Example 2

 Patient S., 38 years old, condition after mitral valve replacement surgery, initial serum potassium of 2.8 meq / l. Before treatment: sinus tachycardia 105 per minute, impaired repolarization processes. An hour after the start of treatment: sinus rhythm of 83 per minute, the processes of repolarization improved, the amplitude of the T wave in all leads increased.

 The proposed method allows to reduce the time of normalization of ECG in patients with hypokalemia, to improve repolarization processes, to restore normal sinus rhythm in patients with arrhythmias caused by electrolyte disturbances (specifically, low potassium level in blood plasma).

Sources of information:
1. A. p. 908377, MKI A 61 N 1/30, c. 2974784 from 08.19.80, publ. 02/28/82.

 2. Maslov A. G. "The use of transcardial galvanization in the treatment of acute myocardial infarction" - an abstract of a dissertation for the degree of Doctor of Medical Sciences, - Barnaul, 1994.

 3. "The use of galvanization according to the transcardial method in the complex therapy of the acute stage of myocardial infarction" - information letter, - Health Committee under the administration of the Altai Territory, - Barnaul, - 1993.

Claims (1)

 The method of intravenous administration of potassium in arrhythmias associated with electrolyte disturbances, characterized in that the potassium chloride solution is introduced by electrophoresis with a small direct current of 40-80 μA, while a positively charged needle electrode is introduced at the site of intravenous infusion of potassium chloride, and a negatively charged plate electrode strengthen on the chest of the patient in the projection of the heart.