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Extracorporal methods of detoxication of acute mushroom poisoning of children


Author: Sergiu Postolache
Degree:doctor of medicine
Speciality: 14.00.37 - Anaesthesiology and Reanimathology
Year:2005
Scientific adviser: Boris (decedat) Pîrgari
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Eva Gudumac
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 15 December, 2004
Approved by NCAA on the 27 January, 2005

Abstract

Adobe PDF document0.18 Mb / in romanian

Thesis

CZU [613.2-099+615.93]-053.2-08

Adobe PDF document 0.50 Mb / in romanian
100 pages


Keywords

plasmopheresis, hemosorbtion, acute of mushroom poisoning of children,fermethemy, hemodynamics

Summary

There were 101 children in the department of the intensive therapy of toxicology and hemodialisis at the scientific research institute of the mother and child’s health protection. Extracorporal methods of detoxication, plasmopheresis and hemosorbtion with the help of the obsober SUGS were carried out in the treatment of 70 children at the age from 1 to 15 years old. On different stages of research indices of belirubin fractions, aminotransferesis, protrombinic index, fibrinogen, cholesterol, β lipoproteids, common protein, urea, content of glycose, K+ Na+, level of cortisol, creatinin, lipids peroxide oxidation system, antioxidant protection, index of acide alcaline state have been studied.

Comparative estimation of desintoxication effectiveness of plasmaferesis and hemosorbtion with traditional conservative intensive therapy was carried out. The analysis of our clinical material showed that on the first day of poisoning it is difficult to determine the degree how dangerous is the illness. After the comparative analysis of the dynamic of changes of clinico-biochemical indexes we found out that children with the light degree of toxication had biochemical indexes which remain in the limit of physiological parameters during the whole period of observations.

After 36-40 hours since the moment of poisoning genuine differences in the groups of middle danger and in the dangerous groups according to such indexes as ALAT and ASAT, urea protrombin index cholesterol have been found. Genuine differences in ALAT, ASAT, bilirubin, protrombin index, cholesterol, β lipoproteid, urea, cortison have been found in the groups with dangerous and extremely dangerous degree of poisoning beginning since the third day of the illness.

On this ground, it is evident , that the correct estimation of the functional state, clinicobiochemical indexes determines differential diagnostic of the degree how dangerous the poisoning is, thus the tactics of treatment of the volume of the conservative and active surgical methods of detoxication depends on it.