ABDOMINAL SEPSIS AND ACUTE RESPIRATORY DYSFUNCTION

Khomko, Randiuk, Sydorchuk, Kyfiak, Khomko
unpublished
Ключевые слова: абдоминальный сепсис, патогенез, респираторная дисфункция. Резюме. Цель исследования состоит в том, чтобы определить изменения функционального состояния дыхательной системы у больных с абдоминальным сепсисом (АС). Проведено сравнение у семи пациентов с АС и 9 пациентов группы контроля после плановых операций. рО2/рСО2 после вентиляционного теста и 5 мин вдыхания 100% O2 являются наиболее показательными. Сделан вывод о необходимости коррекции тактики лечения таких больных в том
more » ... ких больных в том числе включением кислородотерапии в протокол лечения. Abstract. The aim of the study is to find changes of the functional state of the respiratory system in abdominal sepsis (AS) patients. Seven patients with AS and 9 control group patients after planned surgery have been compared. рО2/рСО2 after ventilation test and 5 min respiration with 100% O2 are most indicative. The conclusion is drawn concerning the necessity to correct treatment tactics of such patients including oxygen enriched therapy into the protocol of treatment. Introduction. Abdominal sepsis (AS) is accompanied by shock or close to shock condition of the patient, and one of its signs is tachypnea and organic or multiple organ dysfunction (hypoxemia, impairment of consciousness, poly-/ oliguria, hy-perlactatemia, etc.). These changes in the body connect with the development of hy-poxic conditions and are caused by three factors: decreased level of рО 2 , long stay under conditions of oxygen deficiency, and individual susceptibility to oxygen insuf-ficiency [2, 4]. Stimulation of the respiratory center by the impulses coming from the vascular chemoreceptors (mainly sinocarotid and aortic zones) with changes of the blood chemical content (decreased level of рО 2 , accumulation of hydrogen ions and carbonic acid), results in hyperventilation, which is indisputable positive reaction to hypoxia, but it has negative outcome as well, as it is accompanied by carbonic acid excretion, its reduced level in the blood and development of hypocapnia [1, 3]. At the same time, considering severity of the condition of such patients, comprehensive examination of the functional state of the respiratory system in case of AS is not adequate. The aim of the study is to find disorders of the functional state of the respiratory system in patients with abdominal sepsis. Tasks: 1. Find disorders of the functional state of the respiratory system in patients with abdominal sepsis. Material and methods. Seven patients with AS (І group) [2], nine patients after planned surgery on uncomplicated hernias of the anterior abdominal wall or varicose veins on the lower limbs (ІІ group) have been examined. The control group (ІІІ group) included 12 healthy and practically healthy volunteers. Anamnesis of all the
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