THE DYNAMICS OF CYTOLYSIS MARKERS UNDER CONDITIONS OF ACUTE BLOOD LOSS COMPLICATED BY LIMB ISCHEMIA-REPERFUSION AND THEIR CORRECTION BY CARBACETAM
DOI:
https://doi.org/10.11603/mcch.2410-681X.2020.v.i2.11354Keywords:
acute blood loss, limb ischemia-reperfusion, cytolytic syndrome, carbacetamAbstract
Introduction. The main means of saving the wounded on the battlefield in conditions of massive blood loss from the limbs is the use of a hemostatic tourniquet. It is known that complete bleeding of the extremity for 2 hours during the reperfusion period is accompanied by activation of lipid peroxidation processes, which increases with acute blood loss, is accompanied by degradation of cell membranes and causes the development of cytolysis syndrome.
The aim of the study – to determine the dynamics of cytolysis markers in the presence of acute blood loss complicated by limb ischemia-reperfusion and the efficacy of their correction by carbacetam.
Research Methods. In experiments on nonlinear white male rats under thiopental sodium anesthesia, two-hour limb ischemia was simulated followed by reperfusion, acute blood loss (20 % of the circulating blood volume), and these injuries were combined. In a separate study group in conditions of acute blood loss and limb ischemia-reperfusion, rats were injected intraperitoneally with a dose of 5 mg/kg of animal weight for rats with a corrective purpose. In the control group, rats were anesthetized. After 1 and 2 hours, and also after 1, 7 and 14 days under thiopental sodium anesthesia, experimental animals were removed from the experiment by the method of total bloodletting from the heart. The content of cytolysis markers in the blood serum was determined: the activity of alanine and aspartate aminotransferases (AlAT, AsAT).
Results and Discussion. Modeling of limb ischemia-reperfusion was accompanied by a pronounced cytolytic syndrome, which, in comparison with the control, was manifested by a significant increase in serum activity of AlAT and AsAT after 3 hours and 1 day of observation. Starting from 7 days, the indicators returned to normal. Modeling of acute blood loss deepened the activity of cytolysis processes. The studied parameters were greater than the control level at all observation periods with a maximum after 1 day of the experiment and significantly exceeded the parameters of the research group, in which only limb ischemia-reperfusion was modeled. In conditions of acute blood loss complicated by ischemia-reperfusion of the limb, the disorders were more significant. The studied parameters significantly exceeded the control and other research groups during all observation periods: AlAT activity – after 1–14 days of observation, AsAT – after 2 hours – 7 days. The use for the correction of carbacetam in rats with acute blood loss complicated by limb ischemia-reperfusion showed that after 7–14 days of its use, the activity of AlAT and AsAT in blood serum decreased significantly compared to animals without correction, but did not reach the control level.
Conclusions. The results obtained indicate a significant role of cytolysis processes in the pathogenesis of acute blood loss complicated by limb ischemia-reperfusion, as well as the prospect of using carbacetam as a comprehensive tool to reduce the manifestations of limb ischemia-reperfusion in acute blood loss.
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