Homeostasis-securing therapy and statusmetria.
Statusmetria allows to define the effective levels of oxygen status. The conception of Syndrome Intensive Care (SIC) has exhausted itself and invariable outcomes of SIC of Multiorgan System Failure (MOSF) confirms that. Therefore, an alternative to SIC should be advanced. Efficiency of treatment has been assessed in 257 patients with MOSF using values of metabolic rate and ability of the organism to cover it by oxygen and substrate supply. Oxygen Pulse (OP) and Index of Efficacy of Oxygen Transport (IETO2) were monitored. Intensive care was considered to be Homeostasis-Securing Therapy (HST) if the energostructure deficit was eliminated and the necessary recovery of regeneration rate was restored. OP in patients with MOSF was 0.8 mL.m-2 or less and IETO2 was 2.4 units in SIC. We managed to maintain an OP of 1.0-1.7 mL.m-2 and an IETO2 of 1.9-2.4 units in HST. 41 patients out of 135 with MOSF survived in SIC and 96 patients out of 122 survived in HST. The efficiency of HST appeared to be twice as much as the efficiency of SIC. Conception of homeostasis-securing therapy is advancing. The conception provides restoration of regeneration rate due to the effective elimination of energostructure deficit compared to SIC. The concept may be a basis of a new technology for the treatment of MOSF.
Shifrin
G A
GA
Institute of Physician Postdiploma Education, Department of Anaesthesiology and Reanimatology, Zaporozhye, Ukraine.
D000328:Adult; D001803:Blood Transfusion; D003422:Critical Care; D004734:Energy Metabolism; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006440:Hemofiltration; D006706:Homeostasis; D006801:Humans; D008297:Male; D013677:Medical Laboratory Science; D008991:Monitoring, Physiologic; D009102:Multiple Organ Failure / Q000097:blood / Q000628:therapy*; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D010956:Plasmapheresis; D012038:Regeneration; D015996:Survival Rate; D016896:Treatment Outcome; D014692:Ventilation-Perfusion Ratio
D010100:Oxygen