[Correlation between biochemical parameters of oxidative stress, endogenous intoxication and regulation of vascular tone in patients with burn injury].

Burn injury is accompanied by the formation of reactive oxygen species (ROS). Excessive production of ROS results in oxidative stress. Peroxidation damage of proteins causes their degradation and the formation of toxic fragments con- tributing to the development of endogenous intoxication. Furthermore, burns cause pronounced inflammatory reaction in the lesion site leading to poor circulation. The purpose of this study was an investigation of relationship between disturbances in the prooxidant/antioxidant system, severity of endogenous intoxication and disturbances of endogenous vascular regulation to assess the severity and prognosis of complications in patients with burn injury. 26 patients with- burn injury were investigated; they were divided into 2 groups according to the severity of injury on the basis of Frank index (FI): group 1--FI < 60 CU and group 2--FI ≥ 60 CU. The investigation of blood serum was performed on 1-3, 7, 14, 21 and 28 day after burn injury. Malondialdehyde (MDA), total antioxidant status (TAS), the level of middle weight molecules, stable metabolites of nitric oxide (NOx) and angiotensin-converting enzyme (ACE) activity were determined in the serum. Significant increase of MDA level, decrease of TAS and NOx level were found in two groups of patients throughout the observation period. We also found a disturbance in coupled interaction of NO and ACE. These data point to the development of oxidative stress and imbalance in endogenous regulation of vascular tone. There was a trend toward more pronounced oxidative stress in group 2. Significant correlations between parameters of oxidative stress, endogenous intoxication, endogenous factors of vascular regulation, depth of burn injury and FI were obtained in two groups. MDA, TAS can serve as one of the prognostic markers of condition severity of burned patients and therapy adequacy.

[Effect of normobaric hyperoxia on cerebral oxygenation, metabolism and oxidative stress in patients with subarachnoid hemorrhage caused by intracranial aneurysm rupture].

The development of cerebral vasospasm in subarachnoid hemorrhage (SAH) due to cerebral aneurysms rupture results in cerebral circulation disturbances. Application of normobaric hyperoxia can be an effective way for improving of oxygen delivery to injured brain tissues. The purpose of this study was to assess of normobaric hyperoxia influence on intracranial pressure (ICP), cerebral oxygenation and metabolism, oxidative stress and endogenous factors of vascular regulation in II critically ill patients with nontraumatic SAH due to cerebral aneurysms rupture. Increase of FiO2 from 0.3 to 0.5 and 1.0 was accompanied with brain oxygen tension (PbrO2) increase and cerebral extraction ratio for oxygen (O2ER) decrease. Application of normobaric hyperoxia had no effect on ICP, cerebral perfusion pressure, arterial blood pressure and cerebral metabolism. The results obtained from patients with nontraumatic SAH showed an evident increase of oxidative stress which had a significant effect on vascular endothelial function, causing an imbalance in the endogenous regulation of vascular tone. Application of normobaric hyperoxia was not accompanied by an increase of free-radical processes in critically ill patients with nontraumatic SAH due to cerebral aneurysms rupture.

[The dynamics of endogenic intoxication in patients with extensive burns].

The sampling consisted of 22 patients with extensive burns with total affected area from 20% to 84% of body surface and with deep burns area from 10% to 40%. The suppurative complications in the form of sepsis were diagnosed in 10 and the transitory bacteremia in 12 victims. The total and effective concentration of albumin, the content of medium molecular peptides in dynamics at 1-3, 7, 14 and 21 days from the moment of trauma were detected to objectively evaluate the endogenic intoxication. The degree of intensity of endogenic intoxication was studied using such integral indicator as effective utilization factor In patients with extensive burns the endogenic intoxication was diagnosed on the basis of total and effective concentration of albumin and increase of content of medium molecular peptides. However the detection of endogenic intoxication of the basis of effective utilization factor is a more informative as compared with the analysis of these indicators separately and, hence, it promote the prescription of more appropriate disintoxication therapy its effectiveness evaluation including.