“Reach the cells”: microcirculatory support

A. Lymanska
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Abstract

Background. Vessels of the microcirculatory tract provide regulatory, drainage, thermocontrol and signal functions. Disorders of these vessels are the part of the pathogenesis of coronary heart disease, endarteritis obliterans, Raynaud’s disease, etc. Common causes of microcirculation disorders include disorders of central and regional blood circulation, impaired blood volume and viscosity, impaired permeability of microvessel walls. Objective. To describe the features of microcirculatory support. Materials and methods. Analysis of literature sources on this topic. Results and discussion. In order to improve microcirculation, various drugs are used: antiplatelets, anticoagulants, antioxidants, and nitric oxide donors. The purpose of these drugs are to improve the rheological properties of blood, to improve the delivery of nutrients to the vascular wall, to regulate the vascular tone, and to improve endothelial function. Reosorbilact (“Yuria-Pharm”) opens precapillary sphincters, increases the area of blood contact with the target cell, improves tissue oxygenation and rheological properties of blood. Reosorbilact includes such components as sorbitol, basic cations (Na, Ca, K, Mg) and sodium lactate. Sorbitol is used for urgent energy needs, metabolized and stored as glycogen, has a disaggregating effect, improves microcirculation and tissue perfusion. The hyperosmolar action of Reosorbilact is to stimulate the flow of fluid from the intercellular space into the vascular bed. Correction of metabolic acidosis with Reosorbilact is slower than due to sodium bicarbonate buffer, so this solution does not cause severe fluctuations in pH. The detoxifying effect of Reosorbilact involves washing of metabolites and toxins out from damaged cells, tissues and organs, followed by their rapid excretion due to increased diuresis. The improvement of liver microcirculation and replenishment of glycogen depot, which normalizes the functional state of hepatocytes and enhances physiological detoxification, is an additional beneficial effect. Hemodilution is also important, because it allows to reduce the content of toxic metabolites in blood plasma. In addition, Reosorbilact gently stimulates peristalsis, has choleretic and cholekinetic effects, reduces bilirubin and creatinine, improves energy metabolism, stabilizes systemic hemodynamics, reduces the symptoms of pain due to anti-edematous effect, and accelerates wound healing. Reosorbilact can be considered a drug № 1 for low-volume infusion therapy. The positive hemodynamic effect of the drug is manifested within 2-3 hours. Reosorbilact promotes the transition of the hypokinetic type of blood circulation into eukinetic due to the redistribution of extracellular fluid into the vascular bed. The drug should be prescribed at a dose of 7 ml/kg of body weight for 5-7 days or until the symptoms of intoxication are reduced. Conclusions. 1. Vessels of the microcirculatory tract provide regulatory, drainage, thermoregulatory and signal functions. 2. Common causes of microcirculation disorders include disorders of central and regional blood circulation, disorders of blood volume and viscosity, impaired permeability of microvessel walls. 3. Reosorbilact improves tissue oxygenation and rheological properties of blood, promotes washing of metabolites and toxins out from damaged cells, normalizes the functional state of hepatocytes, stimulates peristalsis, stabilizes systemic hemodynamics.
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“直达细胞”:微循环支持
背景。微循环束血管具有调节、排水、温度控制和信号功能。这些血管的病变是冠心病、闭塞性动脉内膜炎、雷诺氏病等的发病机制的一部分。引起微循环障碍的常见原因包括中央和局部血液循环障碍、血容量和黏度受损、微血管壁渗透性受损。目标。描述微循环支持的特点。材料和方法。对这一主题的文献来源进行分析。结果和讨论。为了改善微循环,使用了各种药物:抗血小板、抗凝血剂、抗氧化剂和一氧化氮供体。这些药物的目的是改善血液的流变特性,改善营养物质向血管壁的输送,调节血管张力,改善内皮功能。Reosorbilact(“Yuria-Pharm”)打开毛细血管前括约肌,增加血液与目标细胞接触的面积,改善组织氧合和血液的流变特性。山梨醇包括山梨醇、碱性阳离子(Na、Ca、K、Mg)和乳酸钠等成分。山梨醇用于紧急能量需求,代谢并储存为糖原,具有分解作用,改善微循环和组织灌注。Reosorbilact的高渗作用是刺激液体从细胞间隙流入血管床。与碳酸氢钠缓冲液相比,用Reosorbilact矫正代谢性酸中毒的速度较慢,因此该溶液不会引起ph值的剧烈波动。Reosorbilact的解毒作用包括将受损细胞、组织和器官中的代谢物和毒素冲洗出来,然后由于利尿增加而迅速排出。肝脏微循环的改善和糖原储备的补充,使肝细胞的功能状态正常化,增强生理解毒,是一个额外的有益作用。血液稀释也很重要,因为它可以减少血浆中有毒代谢物的含量。此外,Reosorbilact温和刺激蠕动,具有降胆和胆动作用,降低胆红素和肌酐,改善能量代谢,稳定全身血流动力学,减轻因消肿作用引起的疼痛症状,加速伤口愈合。Reosorbilact可以被认为是低容量输注治疗的药物№1。药物的血流动力学阳性作用在2-3小时内显现。由于细胞外液重新分配到血管床,Reosorbilact促进了低动力型血液循环向正动力型血液循环的转变。用药剂量为每公斤体重7毫升,服药5-7天,或直至中毒症状减轻。结论:1。微循环束血管具有调节、排水、体温调节和信号功能。2. 引起微循环障碍的常见原因包括:中央和局部血液循环障碍、血容量和黏度障碍、微血管壁渗透性受损。3.Reosorbilact改善组织氧合和血液流变学特性,促进代谢产物和毒素从受损细胞中冲洗出来,使肝细胞的功能状态正常化,刺激蠕动,稳定全身血液动力学。
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