Application of indirect electrochemical oxidation of blood in a complex of intensive therapy in children with urolithiasis complicated with chronic kidney disease
Objective. To study the efficacy of sodium hypochlorite in children with urolithiasis complicated by chronic kidney disease (CKD).
Materials and methods. The results of the use of sodium hypochlorite 0.03-0.06 % in the pre- and postoperative period in 20 patients with urolithiasis complicated by stage IV CKD were analyzed. The indices of endogenous intoxication in venous cubital blood (VСK), mixed venous blood (MVB) flowing to the lungs and arterial blood (AB) flowing from the lungs were studied. Indirect electrochemical oxidation of blood (IEOB) was carried out in 20 patients with stage. For children under 12 years old, we used 0.03 %, and for the older age group from 12 to 18 years old ‒ 0.06 %, the volume of the injected solution did not exceed 1/10 of the patient’s CBV per infusion, at a rate of 40-60 drops/min. We have studied the use of sodium hypochloride (NaCIO) as a component of complex intensive care (CIC) in preoperative preparation in children with urolithiasis complicated by CKD and the effect of sodium hypochloride on detoxification lung function (DLF).
Results. There was a significant increase in low molecular weight toxic substances (creatinine, calurea), average mass molecules (AMM), lipid peroxidized products, oligopeptides of a high necrotic body mass (NB), circulating immune complex (CIC), integral indicators of toxicity leukocyte index of intoxication and index of intoxication, as well as a decrease in antioxidant protection, more pronounced at sub- and decompensated stages of DLF impairment in the examined group of patients before treatment in the basin of VKK, VCK and AB. In 7 (35.0 %) patients ‒ 1b compensated, in 13 (65.0 %) ‒ subcompensated stage of impairment.
Conclusions. CIC with the use of IEOB in the preoperative preparation by infusion of sodium hypochlorite in this subgroup of patients significantly improved DLF in relation to NB, CIC and high-weight oligopeptides. The use of NaCIO leads to inactivation of the entire spectrum of AMM and large toxic molecular compounds fixed on the membranes of blood corpuscles, and also, ensures the transformation of hydrophobic metabolites into hydrophilic ones, which are actively excreted by excretory organs.
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