PROTOCOL CLINICAL ENTEROSORBENT ABSORBATION POLISORB MP
Under the Approval of Main Army-Medical Direction of Ministry of Defence of RF №161/7/1/1859 dated 07.04.2000г. in Hematological Center (HC) named after the acad. N.N. Burdenko from 10.04. 2000 to 05.05.2000 Clinical enterosorbent absorbation was carried out POLYSORB MP (CJSC Polysorb, Chelyabinsk).
In order to achieve the assigned objective this medicine was administrated in the organism of 77 patients. These patients are undergoing treatment in different units of HC named after N.N. Burdenko in the following groups:
1) 15 patients with coronary disease which were cardia bypass open-heart operated;
2) 42 patients with infectual diseases (acute enteric infection, virus hepatitis, yersinia infections, pseudotuberculosis);
3) 10 patientwithheroinintoxication.
For POLYSORB clinical effect appraisal different clinical tests besides clinical methods were carried out (leucocytosis, band changes, blood-sedimentation test, leucocytal intoxication quotient, medium molecules levels, glucose, creatinine, GOT, GPT, urea nitrogen, bilirubin in blood, urea and blood diastase).
Open-heart surgery usesfactors of considerable force and depth: cardia bypass, total body hypothermia, pharmaco hypothermic cardioplegia, anoxic myocardial ischemia. In post-operation period some patients had considerable changes in phlogistic response, and life support can be affected (heart-vascular system, GI tract, eliminative organs and detoxication), it leads to endotoxemia progression. Fifteen patients with coronary heart disease underwent myocardial revasculization surgery and used POLYSORB MP. There were twenty patients in the control group; these patients received a course of congestive heart failure operative therapy. Both groups were strictly randomized (randomization tests: coronary affection, pumping ability affection of left ventricle, age of patients, associated diseases, extent and character of operational intervention; exception criteria: perioperative acute myocardial infarction, severe acute cardiovascular collapse, profuse blood loss).
Technology. Enteral use of medicine was prescribed in the form of aquatic suspension after extubation in early postoperative period. Drug dose made 200 mg/kg/day, is used 3 times per day 2 hours after meals and other medicine use. Enterosorbent course takes 5 days.
POLYSORB MP has no taste and odor, that’s why tolerance is good.
Enterosorbent presentation of POLYSORB MP consists in:
1) improvement of subjective general mend (1-2 day before than subjective results in control group);
2) absence of dyspeptic disorder in post-operation period (in control group 5 patients felt sick and voimit);
3) lower intensity of postpericardiac syndrome.
After laboratory findings analysis in both groups where patients used enterosorbent POLYSORB MP, vitalses normalization is earlier (4-5 days) than it is in control group (8-10 days): creatinine, urea nitrogen, glucose, blood serum diastase, medium molecules levels, intoxication leukocytic index. Four patients with diabetes mellitus of second stage showed positive results in enterosorbent use, consisting in carbohydrate metabolism subcompensation, the second day after post-operation period and during 5-8 days after post-operation period carbohydrate metabolism subcompensation was still evident in control group analyses.
Consequently, enterosorbent POLYSORB MP was used by patients who underwent bypass open-heart operation. This medicine is an active and harmless component in post-operation treatment, optimizes base treatment, considerably improves post-operation results. Patients quickly recover and leave surgical hospital (2 days before than patients of control group).
Acute infectious diseases. Forty-two patients with intermediate and severe forms of acute infectious diseases used POLYSORB MP. There are thirty-five patients in control group, these patients didn’t use enterosorbent.
Technology. After admission, medicine in the form of aquatic suspension is prescribed to take in orally. Daily dose makes 200 mg/kg/day. A patient with acute diarrheal syndrome takes in daily dose during 5 hours every hour. Further medicine is prescribed to be taken four times per day 1.5-2 hours after meals and after other medicine. Enterosorbent POLYSORB MP was used in combination with eubiotics, probiotics treatment (bifidumbacterin forte (Probifor), Flonivin, Bactisubtil, Normoflor).
Twenty patients with acute enteric infection (salmonellosis, shigellosis, colibacillosis, bacterial food poisoning) shown the following results:
1) diarrheal syndrome period decreased for 2 days (in control group 4-5 days);
2) there was no meteorism the second day after enterosorbent was taken in. But 40 % of patients had symptoms of meteorism during 7 days of base therapy after admission;
3) general intoxication syndrome decreased for 1-2 days with POLYSORB MP use (for 4-5 days in control group);
4) there was no anorexia the first day after POLYSORB MP use (in control group 50 % patients suffered from loss of appetite during treatment of 6-7 days).
Enterosorbent POLYSORB MP use quickly reduced endointoxication and anorexia syndrome in the organism of 15 patients with virus hepatitis А and В (clinical overt forms of severe and intermediate forms). In the period of fast recovery 7 patients with Yersinia syndrome and pseudotuberculosis deceases shown fast antibiotic colitis resolution caused by dysbacteriosis.
Therefore POLYSORB MP is high-effective enterosorbent used in acute infectious disease complex therapy.
POLYSORB MP was used to treat 10 patients with heroin intoxication in order to prepare them for pharmacologic detoxication. Fourteen patients with heroin intoxication formed the control group, they didn’t take in enterosorbent.
Technology. Probe with aquatic suspension was administrated in stomach during the period when the patient was under anaesthesia and after intubation of trachea and APV. Daily dose of POLYSORB MP was administrated each 2,5 hours. After pharmacological detoxication under anaesthesia the probe was pulled out with active aspiration of gastric contents. Patients which used POLYSORB MP showed the following results:
1) there is no dyspeptic disorder (sickness, vomiting, loose stool);
2) negative tests in 100 %, there are no opioids in urine after pharmacological detoxication under anaesthesia (in control group these tests were positive in 30 %). GI tract absorbs and eliminates a portion of heroin.