rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2014-3-59-74rmt-1402Research ArticleПРАКТИКУЮЩЕМУ ВРАЧУFOR PRACTIONERИНФУЗИОННЫЕ АНТИГИПОКСАНТЫ ПРИ КРИТИЧЕСКИХ СОСТОЯНИЯХ У ДЕТЕЙInfusion Antihypoxants in Children with Critical ConditionsАлександровичЮ. С.AleksandrovichYu. S.Jalex1963@mail.ruПшенисновК. В.PshenisnovK. V.Санкт-Петербургский государственный педиатрический медицинский университет, Санкт-ПетербургРоссияSaint Petersburg State Pediatric Medical Academy, Saint PetersburgRussian Federation2014280620141035974Copyright © Александрович Ю., Пшениснов К., 20142014Александрович Ю., Пшениснов К.Aleksandrovich Y., Pshenisnov K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1402

Гипоксия и повреждение митохондрий является ключевым звеном патогенеза и танатоненеза при критическом состоянии, что свидетельствует о необходимости ее профилактики и максимально быстрого устранения.

Цель исследования — провести анализ эффективности и безопасности применения инфузионных антигипоксантов у детей в критическом состоянии на основании результатов научных исследований.

Материалы и методы

Материалы и методы. В анализ включены доступные исследования, посвященные инфузионной терапии у детей и работы по использованию инфузионных антигипоксантов у взрослых за период с 2005 по 2013 г. Поиск проводили в медицинских базах PubMed и Cochrane Library при наличии свободного доступа к публикации.

Результаты исследования

Результаты исследования. В анализ было включено 70 исследований. Представлена патофизиология и патобиохимия гипоксии критических состояний у детей, детально рассмотрены современные принципы ее коррекции путем инфузионной терапии. Особое внимание уделено анализу исследований, посвященных оценке эффективности и безопасности растворов янтарной кислоты у детей. Продемонстрированы основные показания и противопоказания для их использования.

Заключение

Заключение. Применение инфузионных антигипоксантов у детей на основе субстратов цикла Кребса (малат, сукцинат) является эффективной и перспективной методикой интенсивной терапии и коррекции гипоксии критических состояний, как у взрослых, так и у детей. Учитывая, что работы по применению инфузионных ангитигипоксантов у детей в настоящее время немногочисленны, необходимо проведение дальнейших исследований. 

Hypoxia and mitochondrial damage are a key component of the pathogenesis and tanatogenesis of a critical condition, suggesting the need for its prevention and maximally rapid elimination.

Objective

Objective: to analyze the efficacy and safety of infusion antihypoxants used in critically ill children from the results of researches.

Materials and methods

Materials and methods. Available investigations dealing with infusion therapy in children and papers on the use of infusion antihypoxants in adults in 2005 to 2013 were sought in the medical databases PubMed and Cochrane Library with their free availability and analyzed.

Results

Results. The analysis included 70 trials. The pathophysiology and pathobiochemistry of hypoxia in critically ill children are given; the current principles of its correction by infusion therapy are considered in detail. Particular emphasis is placed on trials evaluating the efficacy and safety of succinic acid solutions in children. Main indications for and contraindications to their use are demonstrated.

Conclusion

Conclusion. The use of Krebs cycle substrate-based infusion antihypoxants (malate, succinate) is an effective and promising procedure for the intensive therapy and correction of hypoxia in both adults and children with critical conditions. Considering the fact that papers on the use of infusion antihypoxants in children are scanty, there is a need for further investigations. 

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The authors declare that there are no conflicts of interest present.