Characteristics of endotoxicosis in pulmonary gangrene

Abstract

Aim. The study of various indicators of endotoxicosis, including lymphological, with gangrene of the lungs.

Materials and methods. The study group consisted of 21 adult patients with extensive and limited pulmonary gangrene, who were drained of the thoracic or right lymphatic ducts for the treatment of endotoxicosis with subsequent lymphosorption and lymph reinfusion. The control group included 22 adult patients with pulmonary abscesses in the convalescent stage, for whom the right or thoracic lymphatic ducts were drained for therapeutic purposes, followed by lymphosorption and lymph reinfusion for 3 days. The main clinical parameters were studied: the intensity of cough and the daily volume of excreted sputum, its ichorous smell, pain at the site of pathology, body temperature, pulse, respiratory rate, liver size, sleep and appetite. The laboratory parameters were determined – in the blood tests, leukocytosis, toxic granularity of neutrophils, and the leukocyte index of intoxication were detected. Studied the number of molecules of average weight in the blood and lymph. New methods for the diagnosis of endotoxicosis were developed and applied, based on indicators of extravascular fluid of the lungs and indicators of continuous measurement of the volumetric flow rate of lymph flow from the lymphatic ducts.

Results. Pulmonary gangrene is accompanied by severe and extremely severe de grees of endotoxicosis, while the indices of endotoxicosis in the lymph are significantly higher than in the blood. The greatest parameters of endotoxicosis in pulmonary gangrene were determined in the lymph of the right lymphatic duct, which drains 2/3 of the pulmonary lymph. When draining the right or thoracic lymphatic ducts with gangrene of the lungs, the most accurate method for the study of endotoxicosis is the priority method of continuous measurement of the volume rate of lymph flow, taking into account the back pressure of the venous blood pressure.