[Role of disrupting the antioxidant status of the body in forming the endogenous intoxication syndrome in patients with toxic and terminal stages of peritonitis]. / Rol' narushenii antioksidantnogo statusa organizma v formirovanii sindroma éndogennoi intoksikatsii u bol'nykh v toksicheskoi i terminal'noi stadiiakh peritonita.

Fifty-one patients with diffuse peritonitis were treated. 40 of these presented with the toxic stage and 11 had terminal stage with lethal outcomes. Studies of the antioxidant status showed an important role of lipid peroxidation metabolites in the formation of endogenous intoxication during the early postoperative period, manifesting, among other things, by decreased albumin transporting function. Analysis of correlations showed some relationships in the studied parameters which can be used in complex with other values in clinical laboratory diagnosis of endotoxicosis severity in peritonitis and in evaluation of the time course of this condition during intensive care. It can serve as a prognostic criterion of peritonitis development and outcome.

[The immunobiochemical mechanisms of the intoxication syndrome in acute diffuse peritonitis]. / Immunobiokhimicheskie mekhanizmy intoksikatsionnogo sindroma pri ostrom razlitom peritonite.

The course of diffuse peritonitis was studied in 211 patients with the reactive (25 patients), toxic (114), and terminal (65) stages. Besides routine treatment, local abdominal hypothermia, UV exposure of autoblood, and, if indicated, hyperbaric oxygenation and hemoperfusion were used in multiple-modality treatment of these patients. In addition to the common clinical tests, immunobiochemical monitoring of the function of medium-molecular peptides and index of their distribution, as well as of the fractions of circulating immune complexes and of IgA, IgM, and IgG was used to assess the severity of intoxication and treatment efficacy and predict the disease course and outcome. Intoxication of the organism was shown to lead to the formation of immunity shifts, involving, among other things, the humoral immunity.

[Liver function and the lipid metabolic status of patients before and after a surgical intervention on the gastrointestinal tract]. / Funktsiia pecheni i sostoianie lipidnogo obmena u bol'nykh do i posle operativnogo vmeshatel'stva na zheludochno-kishechnom trakte.

Local hepatic bloodflow (LHB) and metabolic processes were examined in patients with abdominal diseases during intensive transfusion and infusion therapy attended by incomplete parenteral feeding. A reduction of LHB and disorders of lipid metabolism were observed before surgery. After surgery LHB was still reduced on days 1-3. Cholestatic and cytolytic syndromes developed after the intervention, and a reduction of the protein-synthesizing function of hepatocytes and disorders of the lipid status were observed. By days 7-10 the protein-synthesizing function recovered, as did the enzymatic activity, but no complete recovery of LHB and lipid spectrum were observed.

[Hyperbaric oxygenation and current methods of detoxication in multimodal intensive therapy of diffuse peritonitis]. / Giperbaricheskaia oksigenatsiia i sovremennye metody detoksikatsii v kompleksnoi intensivnoi terapii razlitogo peritonita.

The course of diffuse peritonitis has been followed up in 219 patients, 20 of these with the reactive, 165 with toxic, and 34 with the terminal stages of the condition. Multiple-modality intensive care included, besides routine therapy, local abdominal hypothermia, UV irradiation of autoblood (UVIAB), and, if indicated, hyperbaric oxygenation (HBO) and hemoperfusion. In addition to clinical tests, immunobiochemical monitoring of medium-molecular peptide fractions MM1 and MM2 and index of their distribution, as well as of circulating immune complexes CIC1 and CIC2 and the levels of immunoglobulins IgA, IgM, and IgG were the criteria for assessing the severity of intoxication and efficacy of intensive care and for predicting the course and outcome of the disease. The results indicate that HBO in combination with hemoperfusion, local abdominal hypothermia, and UVIAB have a positive impact on the clinical picture of the disease and on the time course of markers of endogenous intoxication and humoral immunity in patients with the terminal and toxic phases of diffuse peritonitis.