Pathophysiologic characteristics of the reactive toxic stage of acute suppurative peritonitis and ways to enhance the effectiveness of intensive therapy
Shifrin, G.A.; Aldeshev, A.A.; Taslitskiĭ, L.I.
Patologicheskaia Fiziologiia i Eksperimental'naia Terapiia 6: 40-44
1989
ISSN/ISBN: 0031-2991 PMID: 2628881 Document Number: 342411
The oxygen regimen, circulation, and metabolism were studied in 95 patients in the reactive-toxic stage of diffuse purulent peritonitis. The results of cluster analysis made it possible to determine the clinical and pathophysiological features of the phases of the disease. The phase of compensation was characterized by disorders of mass exchange of plasma water which led to increased index of transcapillary exchange and increased excess of lactate. These parameters of tissue metabolism were grouped into one cluster together with the oxygen regimen value and mean arterial pressure. The other cluster was formed of the values of oxygen consumption and the values of oxygen systemic and vascular tissue transport and the hemodynamic parameters. In the phase of decompensation the homeostasis parameters were grouped into another 2 clusters. The first contained the indices of transcapillary exchange of oxygen and water, the other--those of the intensity of blood oxygen transport function and metabolism. Surgical treatment and inclusion of the sympatholytic agent ornid and the beta-adrenergic agonist alupent in the complex of intensive therapy from the stages of preoperative and anesthesiological management brought homeostasis to a level characteristic of the phase of compensation, as a result of which fatal outcomes were absolutely excluded.