Oxidative metabolic foundations of multiple organ failure in urgent surgery and their correction

Objective. To establish the role of oxidative and metabolic disorders in pathogenesis of multiple organ failure following acute peritonitis and to develop appropriate treatment. Material and methods. The study is based on experimental and clinical results. In a model of peritonitis resulting from acute colonic obstruction with intestinal perforation, we studied functional state of various organs and systems in conjunction with homeostasis disorders. Antibacterial and infusion therapy was prescribed in early stages. The experimental group also included Remaxol. In clinical part, 41 patients with acute purulent-fibrinous diffuse or widespread peritonitis and multiple organ failure were used regarding efficacy of complex therapy, including Remaxol. Results. According to experimental data, organ failure in severe urgent diseases is based on tissue lipid metabolism disorders. Their reduction is possible by influencing the main trigger agents of membrane-destabilizing phenomena. When assessing functional status of organs and systems, we found that 94.7% of patents had two or more organ failures (multiple organ failure) in early postoperative period. This predisposed to complications arose that further worsened prognosis of disease. In the main group, inclusion of Remaxol in complex therapy significantly changed postoperative period. The most important manifestation was less number of multiple organ failure (χ2=4.151, p=0.042) and shorter duration of symptoms. Conclusion. Higher effectiveness of Remaxol therapy in correction (prevention) of multiple organ failure in acute severe peritonitis is associated with rapid positive effect on various parameters of homeostasis and oxidative-metabolic tissue disorders.