Volotovska N. Pathogenic effect of limb ischemia-reperfusion on systemic mechanical trauma manifestations with massive blood loss and its correction

The thesis deals with the estimation of the role of limb ischemia-reperfusion in the manifestations of metabolic and morphological disorders of liver, kidneys, lungs and heart, enhancement of cytolysis and endotoxicosis, development of dyssimmunoglobulinemia caused by massive blood loss, skeletal trauma and their combinations during acuity and pathoformic periods, as well as provement of Thiocetam effectiveness in the correction of identified disorders. It is determined that massive blood loss, skeletal trauma and their combination in the tissues of liver, kidneys, lungs and heart initiate the activation of free radical oxidation of lipids and proteins, increase the content of leukocytes producing reactive oxygen species, reduce the enzymatic and glutathione links of antioxidant protection, increase endotoxicosis with endogenous intoxication products (medium weight molecules, cretinin, urea), violation of humoral immunity and cause structural changes at the stage of acute response to trauma and early posttraumatic period, which is the major factor in tissue damage and the development of systemic organ failure. It is found that additionally induced ischemia-reperfusion of the rats limbs with simulated injuries worsens the course of traumatic disease during all investigated post-traumatic periods. The maximum violations are noted after 3 days of the experiment. Administration of Thiocetam to rats with massive blood loss combined with mechanical trauma and limb ischemia-reperfusion, compared with animals without correction, in the early post-traumatic period increases the stability of antioxidant defense and minimizes impairment of glutathione system, reduces as well as stabilizes the manifestations of cytolysis, creatinine and urea. Less expressed manifestations of morphological disorders in the group of treated animals is also noted.