[Violations of oxygen transport function of hemoglobin in surgical endointoxication and their correction using remaxol].

AIM

To study the effectiveness of remaxol in erythrocytes oxygen transport function correction in patients with surgical endotoxicosis.

MATERIAL AND METHODS

Two groups of patients (main (n = 25) and comparison (n = 27) groups) with acute appendicitis complicated by peritonitis were compared. All patients underwent standard postoperative treatment including infusion therapy 1600--2000 ml/day, antibiotics as combination of semi-synthetic penicillins and aminoglycosides, anesthetic and desensitizing therapy. In the main group daily intravenous infusion of remaxol 400 ml for 5 days was used. The first dose was administered intraoperatively or immediately after surgery. Patients underwent emergency surgery and destructive forms of acute appendicitis accompanied by diffuse purulent or purulent-fibrinous peritonitis were diagnosed. Removal of appendix, debridement and drainage of the abdominal cavity were performed. Observation of clinical and laboratory tests were carried out at admission and in 1, 3, 5 days after surgery.

CONCLUSION

Acute peritonitis leads to changes of hemoglobin conformation and its oxygen-binding capacity according to spectroscopy that is an important factor in the development of general hypoxia. The greatest changes in the hemoglobin molecule were found in the 1st day after surgery as a result of surgical aggression. It is proved that modified conformational state of hemoglobin is associated with processes of lipid peroxidation and endogenous intoxication. Combined therapy with remaxol is effective to correct oxygen transport function of hemoglobin in acute peritonitis. Pronounced positive effect of the drug weakening manifestations of surgical aggression is noted after the first administration. Therapeutic efficacy of the drug is explained by its ability to reduce lipid peroxidation. Rapid recovery of homeostasis including decrease of general hypoxia using remaxol resulted in a clinical benefit.