Endogenous Intoxication

7/30/2019 Endogenous Intoxication

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Endogenous intoxication

(autointoxication) is a syndrome

typical of many pathologic

processes and conditions due to amassive arrival of various toxins

into the bodys internalenvironment.


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In normal conditions the immune systemrecognizes foreign bodies, fixes them withantigen-antibody-complement complexes,

detains them in lymphoid tissue, subjects tophagocytosis and destruction by lysosomalenzymes.

he liver and intestine inactivate a great

amount of liposoluble toxic substances whichunder the impact of chemical reactions convertto hydrophilic ones and are excreted bykidneys.

The lungs eliminate carbon dioxide, water,volatile toxic substances, and metabolicproducts of aggressive fluids.


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Polyorganic insufficiency syndrome is significant

in this respect, too, when it does not matter which

organ began to dysfunction as all systems are

gradually involved into the pathologic process.

The amount of affected organs and systems

has clinical importance as this constitutesthe foundation of prognosis:

in insufficiency of one organ or systemmortality is about 23-40%;

of two organs or systems 53-60%,

three and more 73-89%.


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Forced diuresis

is used when the patient

receives diuretics after infusionof a large amount of fluid (3-5

litres).


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The mechanism of action ofdetoxication therapy is based on

diluting toxic substances with the

administered solutions (of glucose, saline)

fixing them (refortan) with subsequent

destruction or excretion

remove harmful substances (efferent

therapy).


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Along with indisputable success of

drug therapy its downsides are

apparent now:

rise of allergic diseases;

drug tolerance;

psychological and physiologic

dependence of some patients ondrugs.


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In their relation to the bodys own

detoxication system non-

medicamentous methods aredivided in the following way:

Methods enhancing the processes ofnatural cleansing.

Artificial detoxication, the possibility of

temporary replacement of disruptedfunctions.

Special antidote therapy.


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Enhancement of natural cleansing processes Cleansing of the gastrointestinal tract

emetic drugs

gastric lavage (regular or with a tube) intestinal lavage (intestinal lavage, enema)

laxative drugs (magnesium salts, castor oil)

electric stimulation of intestinal peristalsis

infusion therapy and forced diuresis

regulation of enzymatic activity (festal)

therapeutic hyperventilation of lungs (upon poisoningwith substances excreted through the lungs)

therapeutic hyperthermia and hypothermia(sauna for

stimulation of metabolism, therapeutic pyrogens;hypothermia as prevention of hypoxic intoxication insurgery with replaced circulation.

hyperbaric oxygenation.


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Artificial detoxication1. Afferent methods(based on mechanical

removal of toxins together with blood componentsand subsequent dilution of blood).

Blood substitution (exchange transfusion innewborn babies with hemolytic anemia).

Plasmapheresis (discrete and continuous).

Drainage of thoracic lymph duct and all typesof lymph outflow stimulation.


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2. Dialysis and blood filtration

through semipermeable

membranes hemodialysis (artificial kidney is a method based on

using membranes permeable for only low molecular

toxins) hemofiltration and membrane plasmapheresis (with

membranes that are permeable to only water end

electrolyte and catch corpuscular elements)

ultrafiltration with membranes with small porespermeable to only water and electrolytes (in fluid

retention, anasarca, eclampsia)


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3. Sorption methodsbased on usingsorbents, substances that fix toxins. Most often it

is sorbents consisting of active carbon. Extracorporealsorption(hemosorption,plasmasorption, lymphosorption, liquisorption).

Enterosorptrion, intracorporeal method. The

sorbents are active carbon, polyphepam, enterosgel(natural sorbents are bran and cellulose). Thismethod fixes toxins formed in the intestine afterarrival there from blood (up to 12 litres of fluidsecreted in the body passes through the intestine a

day). Vulneosorption, local method. Special sorbents

(emosgent) or dressings of fabrics based on carbonfibres are used.


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4. Electrochemical methodsare basedon electrolysis of solutions and subsequent

oxidation of toxins. Electrolytic oxidation. Indirect electrochemicaloxidation is possible. Electrolysis yields an unstablesolution which upon passing to blood stream releases

active oxygen which oxidizes the toxins. For instancesodium hypochlorite can be used: NaCl NaClOwhich then breaks down to NaCl and O2.

Ozone therapyand ozonation of solutions. O2 + O =O3. The saturated O3 solution is transfused to the

patient, in the blood stream O3 breaks down and thereleased active oxygen oxidizes the toxins. O3-enriched solution can be used for management ofwounds.


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5. Quantum therapy(physiohemotherapy,irradiation or photomodification of blood). The

detoxicating effect of these methods is not verypronounced. It is mostly brought about by the

immune system indirectly.

Ultraviolet radiation of blood. Many methods ofultraviolet radiation of blood have been proposed. Thefirst ones consisted in irradiating blood drawn into avial with bactericidal lamps. Then the continuous-flowmethod was developed when the blood was irradiated

flowing through a tube of quartz glass. The mainquestion in any method is the choice of optimumradiation dose as an overdose causes a condition likeexcessive sun exposure in spring.


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The physical significance of blood irradiation consists in:1) the photon is absorbed by molecule and atom and

passes to a higher orbit (stimulated condition);

2) reversal to usual condition giving energy to thetissues and stimulating physical and chemical processes

in organs and tissues. Thus blood acts as a carrier ofphoton energy.

Physical and chemical processes in the tissues are asfollows: a change of energetic activity of biologicalmembranes, conformation changes of molecules,formation of photolysis products. This induces

biological response of tissues: inflammation stagesbecome shorter, edema reduces, oxygen consumptionby tissues increases, blood flow gets faster,rheological properties of blood improve etc.

L i di ti


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Laser irradiationis a still more complicatedquestion. The laser beam is different from light in that it

is monochromatic and coherent.

Laser irradiation can be different:1.According to the wavelength and the source oflaser energy.In UV part of spectrumCO2 lasers irradiate

In the visible part of spectrum

ruby, sapphire, helium-neonlasers, cuprum-vapour laser.In the infrared partgallium arsenide lasers work.

2.According to their capacity:

High energysurgical lasers (flux >10 Watt/cm) cut tissues andare used in surgeryMedium energylasers coagulate and evaporate tissues (flux

0.4 10 watt/cm)Low energy(therapeutic) lasers are used for blood irradiation.


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Endogenous Intoxication