SU1556680A1 - Method of treating status asthmaticus - Google Patents

Abstract

The invention relates to therapy, in particular to pulmonology. The goal is to reduce the time it takes to stop the status of stage II-III, which is accompanied by a broncho-obstructive syndrome. For this, blood is exfused in a volume of 5-6.5 ml / kg of the patient's body weight, heparin is added and passed through a xenogenic spleen, such as a pig's spleen, and the blood is subsequently reinfused. The method is simple to perform, devoid of the complications of the known methods of treatment, in particular hemosorption, is effective, reduces the time required for stopping the status in case of bronchial obstruction and the effects of severe exogenous intoxication.

Description

The invention relates to medicine, in particular to pulmonology.

The purpose of the invention is to reduce the time of stopping the status of stage II-III, accompanied by broncho-obstructive syndrome.

An example. Sick T., 38 years old, was taken to the intensive care unit in an asthmatic condition of stage II. Last days to stop an attack of suffocation, the use of sympathomimetics is ineffective - an asthmatic condition has developed.

The condition for admission to the intensive care unit is severe. Expressed shortness of breath with difficulty exhaling. Respiratory rate up to 40 min. Blood pressure 170/90 mm RT. Art., pulse 140-160 beats per minute. Due to poor severity of peripheral veins under local anesthesia in the half-sid position, the left femoral vein is punctured. By Seldinger held plastic catheter. Infusion therapy was initiated, hormone and xanthine administration continued, but the effect of the ongoing conservative therapy was not received. It was decided to carry out the treatment by the proposed method. As a predication, 60 mg of prednisolone + 8 mg of dexazone + 2 ml of 1% dimedrol were intramuscularly administered intravenously. In the femoral catheter introduced 30 thousand units. heparin, then in a sterile vial with a volume of 500 ml, containing 2.5 thousand units. heparin, for -25 min performed exfusion of venous blood with a volume of 500 ml (body weight 97 kg). Then the vial was inverted, mounted on a stand, and through a sterile disposable system for blood transfusion, connected to a blood vessel at the xenoorgan gate (pig's spleen), the blood from the vial was passed through a xenoseleen for 20 minutes. Return of blood from xeno-spleen

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carried out in a second sterile vial. Reinfusion of blood from the second vial was performed using a sterile, disposable blood transfusion system. The average rate of blood injection is 80-90 drops per

passed through xeno-spleen for 20 min. The blood was returned from the xeno-spleen to the second sterile vial of 550 ml from the venous vessel at the xenoorgan gate. Blood reinfusion

a minute A similar cycle of action (exfu-5 peripheral vein from the second vial

zi - blood transmission through xeno-performed at a speed of 80-90 drops into the organ - intravenous administration of blood passed through the xenoorgan) was performed sequentially three times. Then continued

a minute Both exfusion and reinfusion of venous blood passed through xeno-spleen were performed under conditions of intensive infusion therapy, administration of xanthines, young operative control of hespasmolytics, glucocorticoid levels. Clinical data dynamics. Described

cycle of actions (exfusion - transmission of blood through xeno-spleen - intravenous. After 5 h, clinical effect was obtained - dyspnea decreased: frequency

respiration decreased from 40 to 28 per minute, 1 (- blood stalk) was performed; the acrocyanosis, lip cyanosis decreased three times. Then continued infukardi from 160 to 100 beats per minute. Blood pressure decreased to 140/85 mm Hg. Art., central venous pressure up to 9 cm of water. Art. An improvement in viscosity of purulent purulent was noted from 50 to 30 per minute, decreases, decrease in body temperature during acrocyanosis, lip cyanosis, tachycardia.

from 140 to 110 per minute, blood pressure dropped to 120/80 mm. Hg Art.,

introduction of xeno-therapy through, introduction of xanthines, glucocorticoids, antispasmodics.

After 6 h, the clinical effect was obtained: dyspnea decreased, respiration rate was reduced from 38.6 to 37, HS.

A day later, the manipulation was repeated without complications.

After 15 days, in a satisfactory condition, for further treatment, she was transferred to a therapeutic hospital.

Example 2. Patient Sh., 22 years old, was taken to the intensive care unit in an asthmatic condition. The last day spent

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central venous pressure was normalized - 8 cm of water. Art. Marked obil40

discharge in the viscous purulent sputum, vitreous bronze casts. For the first time in the last few days, the patient has calmed down and fell asleep.

Positive dynamics was observed in the local hospital, the therapy was unsuccessful, and there were homeostasis indicators. Introducing sympathomimetics against the backdrop of mountains — every other day to consolidate the effect

monal therapy of glucocorticosteroids, the manipulation was repeated without complications,

ineffective. Shut down 12 days in satisfactory

Upon admission to the rezine-state department for further treatment of the reversal, the condition is extremely heavy. Frequently placed in a therapeutic hospital on site

breaths up to 50 per minute. 35 arterial residence. At the control examination the pressure is 150/100 mm Hg. Art., pulse 130-140polnogo after 15 months after discharge

per minute. Despite the cough stimulation, the introduction of saline with broncho- and mucolysis through the microirrigation device does not cough up sputum - single purulent bronchi specimens leave. Through a nosometric simulation of an asthmatic condition, the diagnosis was clarified - in a patient with bronchial asthma, an infectious-allergic form, a severe course in the acute stage. Asthmatichesky-45 III circulatory circle, but produced stage II-III stage. Targeted effect on sympathetic 60 mg of 5-6.5 ml / kg body weight were injected one-step passively slowly intravenously adrenal system as a premedication.

Zolon + 2 ml of 1% solution of Dimedro-sick venous blood during

la dexazone 18 mg intramuscularly. In trouble-15-25 min; 25 thousand units are inserted to the minimum of the destroyed catheter. hepatization of blood cells (-iririna, then into a sterile vial, trocites and platelets) due to an exclusion volume of 500 ml, containing 3 thousand units. The mechanical action of the roller heparin was performed by exfusing the venous pump carrying out an active hemopercrovia of 450 ml. Then flakon wasfusion; minimized difficulties

turned upside down, mounted on a stand, and there is no technical support of the method

A sterile disposable system for re-needing to perform an operation to pour blood connected to the arterial position of an arteriovenous shunt in the vessel in the xenoorganic gate (se-time as puncture catheterization of poor pig pigs), the blood from the vial was venous Seldinger is running

it was revealed from the ward that asphyxiation was not observed during this entire period of attacks.

The advantages of the proposed method are as follows.

In the treatment according to the proposed method, the negative effect of active blood perfusion by the hemosorption apparatus on hemodynamics is excluded - does not occur.

passed through xeno-spleen for 20 min. The blood was returned from the xeno-spleen to the second sterile vial of 550 ml from the venous vessel at the xenoorgan gate. Blood reinfusion

 peripheral vein from the second vial

blood crater) was performed successively three times. Then, the infusion was continued from 50 to 30 per minute, acrocyanosis, lip cyanosis, and tachycardia decreased.

The introduction of the blood passed through the xenoseleen) was performed sequentially three times. Then, the infusion was continued from 50 to 30 per minute, acrocyanosis, lip cyanosis, and tachycardia decreased.

zion therapy, administration of xanthines, glucocorticoids, antispasmodics.

After 6 h, the clinical effect was obtained: decreased shortness of breath, respiratory rate below

central venous pressure was normalized - 8 cm of water. Art. Abundant discharge in the purulent sputum and vitreous casts of the bronchi was noted. For the first time in the last few days, the patient has calmed down and fell asleep.

A circle of blood circulation, but a targeted effect on the sympathetic compartment is made, it is clear that asphyxiation was not observed during this entire period.

The advantages of the proposed method are as follows.

In the treatment according to the proposed method, the negative effect of active blood perfusion by the hemosorption apparatus on hemodynamics is excluded - does not occur.

quickly; there is no need for preoperative preparation; there are no complications characteristic of perfusion of large volumes of blood; no apparatus for hemosorption required; the stopping time of 5 asthmatic conditions by the proposed method is 54% less than when using previously known methods; the effectiveness of further medical treatment is enhanced by enhancing

Thus, the method is simple to implement, free from the drawbacks and complications characteristic of the known methods of treatment, and reduces the time to stop

Claims (1)

Invention Formula A method of treating an asthmatic condition, including venous blood exudation, characterized in that, in order to shorten the duration of arrest of status II-III sensitivity of beta-2 adrenoreceptors of the 10th stage, accompanied by broncho-obstruction of bronchus to endogenous bronchodilators and exogenous effects; The cost of the xenoorgan (pig spleen) is significantly lower than the cost of the blood sorbent bottle. blood syndrome is carried out in a volume of 5-6.5 ml / kg of the patient's body weight, heparin is added to it, carried out through a xenogenic spleen, followed by reinfusion of the blood. Thus, the method is simple to implement, free from the drawbacks and complications characteristic of the known methods of treatment, and reduces the time to stop Invention Formula A method of treating an asthmatic condition, including venous blood exudation, characterized in that, in order to shorten the duration of arrest of status II-III stages accompanied by broncho-obstructive syndrome, blood exhalation is carried out in a volume of 5-6.5 ml / kg of patient's body weight, heparin is added to it, carried out through a xenogenic spleen, followed by reinfusion of blood.