EIS (Endogenous Intoxication Syndrome) 2

Question 1

Stages

Answer 1

Compensated (no clinical signs of toxemia).

Subcompensated (clinical signs of toxemia occur periodically).

Decompensated (clinical and laboratory signs of
autointoxication are pronounced).

Perverted metabolism (the action of toxins is aggravated by the release of inflammatory mediators - cytokines).

Multiple organ failure (impaired function of vital organs).

Question 2

Clinical manifestations

Answer 2

1) Systemic
2) Organ
3) Lack of function of organs and systems (multiple organ failure)

Question 3

Classification

Answer 3

I degree
II degree
III degree
HR
RR
CNS dysfunction
Skin color
Daily diuresis
Intestinal peristalsis

Question 4

Lab Test

Answer 4

Leukocytes
neutrophils
ALT, AST, LDH
Bilirubin
creatinine
Urea
Total protein

Question 5

Markers

Answer 5

• Leukocytosis (Normal LII values range from 0.3 to 1.5)
  -< total protein concentration in the blood plasma, specifically to 45 g/l,
• > Bilirubin. The level of bilirubin over 30 mmol/l causes
• Urea and creatinine. > in the level of urea more than 16 mmol / l and creatinine more than 0.2 mmol / l
• > ALT, ACT, LDH (violation of permeability of cell membranes)
• > lactic acid (energy deficiency and hypoxia)
• Neutrophil/lymphocyte ratio (infection)

Question 6

Severity

Answer 6

MODS (Multiple Organ Dysfunction Score)
SOFA (Sequential Organ Failure Assessment),

Question 7

Detox therapy

Answer 7

1) Reducing the intake of toxins from the source of toxemia
2) Correction of circulatory disorders, hypoxia, water and electrolyte disorders, anemia, hypoalbuminemia
3) Restoration, maintenance and intensification of the capabilities of the body’s natural detoxification system
4) Reducing the concentration of toxins (oral or parenteral hyperhydration)
5) Destruction of toxins (use of antioxidants)
6) Excretion of toxins (forced diuresis after hemodilution
7) Binding of toxins

Question 8

Neutralization of toxic substances

Answer 8

Albumin solution (5, 10, 20% solution)

-Used for hypoalbuminemia.
-Promotes the transition of fluid into the vascular bed from extravascular spaces, which reduces the concentration of toxic substances and reduces tissue swelling.
-Able to form complex physiologically inactive compounds with toxic substances.

Question 9

Hemodilution

Answer 9

Controlled blood dilution

-improves the rheological properties of blood,
-contributes to the normalization of hemodynamics by
-increasing the volume of circulating plasma,
-prevents erythrocyte aggregation.
-reduces the concentration of toxic substances due to their dilution,
i-mproves tissue perfusion and elimination of toxic substances due to the restoration of microcirculation

Plasma-substituting solutions are used as diluents: crystalloids (Ringer’s solution, PlasmaLit), colliodes (Gelofusin).

Question 10

Forced diuresis

Answer 10

The method is based on improving the urinary function of the kidneys and maintaining water and electrolyte balance.

3 stages:
preliminary water load;
the introduction of diuretic substances;
correction of the electrolyte composition.