SU1544433A1 - Method of treating respiratory dificiency of nonspecific pulmonary disease patients - Google Patents

Abstract

The invention relates to medicine, namely to pulmonology, and concerns the treatment of patients with non-specific pulmonary diseases with respiratory failure. The aim of the invention is to reduce the frequency of complications. This goal is achieved by administering heparin in the form of an aerosol in pharmacopoeially acceptable dosages and regimen to patients by inhalation, the administration being carried out with preliminary determination of the content of 2,3-diphosphoglyceric acid in erythrocytes and the level of the latter less than 20 mg mol / g of hemoglobin. The proposed treatment method was applied to 57 patients with non-specific lung diseases. The results indicate the disappearance of respiratory failure under the influence of inhalation therapy with heparin in all patients with acute and protracted pneumonia and a decrease in all patients with chronic lung diseases, which manifests itself in the normalization of indicators of respiratory function, acid-base status nor, the gas composition of the blood and the increase in the level of 2,3-diphosphoglyceric acid in erythrocytes.

Description

The invention relates to medicine, namely, pulmonology, concerns the treatment of patients with respiratory failure and can be used to treat respiratory failure in patients with nonspecific lung diseases, chronic bronchitis, acute and chronic pneumonia, and bronchial asthma.

The purpose of the invention is to reduce the frequency of complications.

The goal is achieved by the fact that, according to the method of treating respiratory failure by inhalation therapy, patients with nonspecific lung diseases, who have 2,3-diphosphogitricgric acid (2,3-DFG) in erythrocytes of blood less than 20 µmol / g of hemoglobin, Inhalation administration of heparin in the form of an aerosol is daily administered at a dose of 10,000-15,000 LAE for 7-10 days.

The advantages offered by the method are the greater efficacy of treating respiratory failure in patients with non-specific lung diseases and greater safety, thereby reducing the frequency of possible complications;

The method is carried out as follows.

Prior to the course of aerosol heparinotherapy in patients with non-specific diseases / nchki, the level of 2,3-DFG in erythrocytes is determined. The indication for the administration of heparin aerosol is the reduction of 2,3-DFG in red blood cells below 20 µmol / g of hemoglobin. In patients with acute pneumonia, the optimal start of treatment is between 1 and 3 days of illness. Patients with chronic obstructive bronchitis and chronic

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pneumonia heparig aerosol is prescribed during the exacerbation of usi signs of respiratory failure

A solution of heparin in a dose of 10,000-15,000 ME is diluted in 3.5 ml of distilled water at 20-25 ° C. The aerosol is created on an ultrasonic inhaler TSI-3 (GDR)

For a patient with respiratory failure, for 3 minutes they give a deep breath of heparin aerosol through a mask connected to an inhaler with a discharge tube. The cprs of the treatment include a 7-10 procedure. At the end of the course of treatment, it is necessary to study the content of 2,3-DFG in erythrocytes and acid and alkaline condition (KSHS) of the blood in order to assess the effectiveness of the treatment carried out. The decrease in respiratory failure in patients with chronic pneumonia and chronic bronchitis and its disappearance in patients with acute pneumonia is indicated by an increase in 2,3-DFG in erythrocytes of more than 25 µmol / g of hemoglobin, an increase in oxygen pressure, normalization of blood KHS and an improvement in respiratory function

The disappearance of respiratory failure in patients with acute pneumonia and its significant reduction in patients with chronic bronchitis compared with treatment by known methods indicate the high efficacy of the method of treating respiratory failure with heparin aerosol. The safety of using heparin aerosol for treating respiratory failure is not confirmed by complications and side effects in all patients treated with heparin. When using a known method, the frequency of complications in the form drastic reduction of blood pressure was 4%, and a side effect - it tsebienie. dizziness, intolerance to the drug occurs in 25% of patients

The use of heparin aerosol in patients with nonspecific lung diseases in the indicated doses does not give hemorrhagic complications, which is confirmed by the absence of significant changes in the coaguloma of the frame. For example, the blood coagulation time after a course of heparinoscopy 10 + 2.2 minutes, plasma tolerance to heparin 11 ± 1.4 min, thrombin time 3 2 ± 0.8 s, thromboplastin time 38.56 ± 1.92 sec Heparin inhalation against the background of traditional therapy, while observing the indicated indications, gives clinical improvement in 100% of cases, restoration of func and external respiration, gas exchange and increased levels of 2,3-FGD in erythrocytes, contributes to a more rapid resolution of acute pneumonia, prevent the transition of acute pneumonia to the protracted course, reducing

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Example A heparin aerosol, obtained on a USI-3 ultrasonic inhaler, was injected for 10 days with 10,000 IU for inhalation to a patient D, 37 years old, who was admitted to hospital with a diagnosis of chronic obstructive purulent bronchitis, a stage of exacerbation, pulmonary emphysema, diffuse pneumosclerosis, DN-Pst. The diagnosis was made on the basis of the patient's complaints, the history of the disease, clinical examination data, fibrobronchoscopy, spirography, blood gas and KHS analysis, and lung radiography. After a course of heparin therapy, the disappearance was recorded. dyspnea, an increase in oxygen pressure in arterial blood from 54 to 85 mm Hg, a decrease in carbon dioxide voltage from 56 to 43 5 mm Hg, an increase in arterial blood pH from 7.32 to 7.40, lung capacity from 2 , 0 (45%) to 3.0 liters (64%), maximal ventilation of the lungs from 41 (38%) to 68 liters (61%), forced expiratory volume from 0.7 (21%) to 1.5 liters ( 50%) The level of 2,3-DFG in erythrocytes increased from 19.4 to 27.8 μmol / g of hemoglobin. The treatment was carried out by the double-blind method of the N patient. The clinical, intellectual and laboratory signs of respiratory failure decreased. Patient Ovelia Accommodations in hospital 18 days

Example 2 The method is carried out according to example 1. Treatment with heparin inhalations is given to patient W, 46 years old, diagnosed with coarse inferior pneumonia on the left, DN-P st. The diagnosis is based on the patient's complaints, anamnesis of the disease, percussion, auscultation, and lung radiography. and bacteriological examination of sputum Methods of spirography and blood gas analysis revealed respiratory insufficiency of the II degree. Changes in the indicators of spirography, KHS, gas analysis and the level of 2.3 DFG after treatment with heparin are followed by The lung capacity before treatment was 2.0 l (49%), after treatment 4.0 l (96%), maximum lung ventilation was respectively 55 (53%) and 81 l (85%), forced expiratory volume 1 4 and 3.7 l oxygen pressure in arterial blood is 63.5 and 77.5 mmHg, carbon dioxide pressure in arterial blood is 46.9 and 44.9 mmHg, pH 7.41 and 7.36, hemoglobin is 18.1 and 24.8 µmol / g In patient III, after treatment with heparin, by the end of the treatment, respiratory failure was not detected, he spent 19 days in the hospital.

The proposed method of treating respiratory failure with heparin aerosol has been applied in 57 patients with nonspecific lung diseases. The results indicate the disappearance of respiratory failure under the influence of inhalation therapy with heparin in all patients with acute and protracted pneumonia and a decrease in all patients with chronic nonspecific lung diseases. . This is manifested in the normalization of indicators of the function of external respiration, KHS, blood gas composition and an increase in the level of 2,3-DFG in erythrocytes.

Claims (1)

The invention of the method of treating respiratory failure in patients with non-specific pulmonary diseases by inhalation administration of drugs, characterized in that, in order to reduce the incidence of complications, heparin is administered by inhalation in the form of an aerosol in pharmacopoeial dosage and regimen, the administration being administered in the preliminary determination of the content of 2,3-diphosphoglyceric acid in red blood cells and the level of the latter less than 20 µmol / g of hemoglobin.