RESUMEN
Possibility of citric intoxication as a complication of therapeutic plasmapheresis is being discussed on the basis of two clinical observations. Hemodynamic reactions to sodium citrate administration have been noted during reinfusion of auto red cell mass. It is suggested that the development of collapsoid reaction, accompanied by a significant decrease in the total peripheral resistance at a stable cardiac output and cardiac index, is determined by the transition of the ionized calcium of the blood into calcium citrate, and thus the violation of the processes regulating the excitement and constriction of the muscular cells in the peripheral arteries. On the basis of further observations (360 therapeutic plasmapheresis procedures) gradual injections of small calcium quantities are recommended for the prevention of citric reactions during reinfusion of auto red cell mass.
Asunto(s)
Citratos/efectos adversos , Plasmaféresis/efectos adversos , Choque/inducido químicamente , Adulto , Ácido Cítrico , Humanos , MasculinoRESUMEN
Complex therapy, using hemosorption in combination with hemodialysis and hyperbaric oxygenation, was suggested for the treatment of patients with terminal stages of icterohemorrhagic leptospirosis. Such complex therapy decreased the mortality rate of patients with terminal stages of icterohemorrhagic leptospirosis from 76-96% to 18-22% and reduced the in-hospital stay from 60-80 to 35-40 days.
Asunto(s)
Enfermedad de Weil/terapia , Hemoperfusión , Humanos , ResucitaciónAsunto(s)
Anestesia General , Hígado/efectos de los fármacos , Anestesia Intravenosa , Animales , Fentanilo/administración & dosificación , Hexobarbital/administración & dosificación , Inyecciones Intraperitoneales , Hígado/fisiología , Circulación Hepática/efectos de los fármacos , Neuroleptanalgesia , Oxibato de Sodio/administración & dosificación , Porcinos , Tubocurarina/administración & dosificaciónRESUMEN
Experiments were performed on mongrel dogs. Biochemical changes of the blood and functional disturbances in the organism were studied after a two-stage devascularization of the liver at different periods after the second stage, i.e. after the ligation of the hepatic artery. Early disturbances in the intermediary metabolism were the consequence of the two-stage devascularization, i.e. of the rise of the pyruvate and the lactate, an increase of ammonia in the blood and serum transaminases. Biochemical changes of the blood precede and accompany the encephalopathia and serious hemodynamic disturbances in the organism. The mentioned method was capable of causing hepatic coma.
Asunto(s)
Encefalopatía Hepática/fisiopatología , Hígado/irrigación sanguínea , Enfermedad Aguda , Animales , Sangre/metabolismo , Determinación de la Presión Sanguínea , Perros , Duodeno/irrigación sanguínea , Electrocardiografía , Electroencefalografía , Ligadura , Derivación Portocava Quirúrgica , Arteria Renal , Estómago/irrigación sanguíneaRESUMEN
Twenty experiments were performed on mongrel dogs. The absorptive and excretory function of the liver in the intact organism and during its isolated perfusion through the portal vein with the use of extracorporeal circulation was studied by means of the bromsulfaline test. The absorptive function of the perfused liver proved to decrease by 50-60 per cent. The rate of bile elimination and plasma clearance was 5-6 times higher at the beginning of the experiment in the intact organism. Later on, the difference in the degree of retention of the hepatic excretory function was reduced. Hypoxia connected with denervation, hepatectomy and the isolated perfusion proper apparently served as the principal cause of reduction of the absorptive-excretory function of the isolated liver.