Kozak D. Systematic violations in pathogenesis of the early and late periods of traumatic disease and their correction

This thesis is devoted to the dynamics of systemic deviations in pathogenesis of severe injury in the acute period, the early and late manifestations of traumatic disease and medical efficacy with neuroprotective action «Carbacetam» in their correction. It is shown that in the pathogenesis of systemic deviation by multiple trauma the leading role is played by the activation of processes of lipid peroxidation, cytolysis and endogenous intoxication, decreasing of antioxidant protection, increasing antigenic load on the body, violation of the immunoglobulin content, and accumulation of proinflammatory cytokines. Marked disturbances of the functional state of the liver, central hemodynamics, autonomic homeostasis, microscopic and ultrastructure structure of the liver, lungs and heart occurred. The dynamics of most of the investigated parameters have recorded two maximal violations – 3-7 and 21 days post-traumatic period. Basic similarity of pathogenic patterns of acute period and early and late manifestations of traumatic disease in experimental animals and humans has been proven. New approach to immunosuppressive therapy system violations due to trauma with the use of drug with neuro-protective action of Carbacetam was established. Under these conditions, the intensity of lipid peroxidation lowered, antioxidant protection improved; the intensity of endotoxemia, content cytolysis markers and circulating immune complexes decreased. Disturbances of humoral immunity, microscopic and ultrastructural violations of liver, lungs and heart tissues were determined. Maximal effect was marked in 28 days when the signs of regenerative processes prevailed.