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"Emergency medicine" 7 (62) 2014

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Experimental evaluation of the method of Air Ion diagnosis of the Compartment syndrome

Authors: Reshetilov Yu.I., Dmitrieva S.M. — State Institution Zaporizhzhya Medical Academy of Postgraduate Education, Ukraine; Tkach A.V. — Crimea State Medical University named after S.I. Georgievsky

Categories: Medicine of emergency

Sections: Clinical researches

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Keywords

non-invasive diagnosis of air ion, Compartment syndrome.

Introduction. The breathing's test by Aеro Ion in the clinic of internal diseases, as a new method of non-invasive diagnosis of diseases, was proposed and are using now. The principle of the method is to record the changes of aero ion content for the main components of air, which the patient exhales (oxygen, carbon dioxide, hydrogen, ammonia, nitrogen, endogenous alcohol, hydrogen sulfide). Wide application of non-invasive technologies is a modern diagnostic priority, and now proposing the task to use the diagnostic method by aero ion-tests in other different areas of clinical medicine. The scientific justification to using the method of the aero ion — testing in diagnostic of Compartment syndrome, based on experimental researches, is the aim of this investigation.

Material and methods of the research. On the 32 adult rabbits line "Butterfly" from the Vivarium of the Crimean State Medical University the Compartment syndrome was modeled. In the upper third the thigh bandage or rubber pneumatic tourniquet to each animal imposed. The samples of air breathing animals, as well as the air around the affected (for Compartment) and the intact limbs segments were taken for researchers. Control tests were carried out at 2 and 4 hours after removing the tourniquet. The Gas composition in this samples was studied in the research laboratory of the Department of General practice-Family medicine and gastroenterology of the State Institution "Zaporizhzhya Medical Academy of Postgraduate Education". With use of the aero ionic's diagnostic complex with selective gas detectors, the indicators of content of oxygen, carbon dioxide, ammonia, nitrogen, endogenous alcohol, hydrogen and hydrogen sulfide was studied. Morphological study of muscle tissue at various stages of simulation of the Compartment syndrome was made. The obtained results were processed by methods of variation statistics, using the special package of computer's applications.

Results. The materials of the morphological investigation was confirmed, that the experimental model of Compartment syndrome meet the conditions of aero ionic-test assessment. At starting of the study, in animals the basic aero ionic samples were: oxygen — 21.181800 ± 4.473001; carbon dioxide — 55.000000 ± 6.217065; ammonia — 49.533331 ± 4.396270; endogenous alcohol — 5.200000 ± 0.421068; hydrogen sulfide — 2.833333 ± 0.891983. Once the overlay harness for lack of exposure aero ionic samples not were selected. Two hours later from the all animals the respiratory and skin samples were took. Content of ions in the respiratory samples was as follows: oxygen — 39.090900 ± 8.659481; carbon dioxide — 29.346-4,4 ± 0.343800; hydrogen sulfide — 3.966667 ± 1.657080. Skin test were as follows: oxygen — 15.000000 ± 6.819862; ammonia — 47.90000 ± 14.09573; endogenous alcohol 11.909100 ± 3.477993; carbon dioxide — 25.30769 ± 6.56629; ammonia — 51.86667 ± 12.89063; endogenous alcohol — 4.200000 ± 0.787746; hydrogen sulfide — 3.866667 ± 1.51997. Two hours later from the all animals the respiratory and skin samples were took. Content of ions in the respiratory samples was as follows: oxygen — 39.0909 ± 8.659481; carbon dioxide — 29.346-4,4 ± 0.3438; hydrogen sulfide — 3.966667 ± 1.65708. Skin test were as follows: oxygen — 15,000000 ± 6.819862; ammonia — 47.90000 ± 14.09573; endogenous alcohol — 11.9091 ± 3.477993; carbon dioxide — 25.30769 ± 6.56629; ammonia — 51.86667 ± 12.89063; endogenous alcohol — 4.200000 ± 0.787746; hydrogen sulfide — 3.866667 ± 1.519970. Within four hours of the start of the experiment the content of ions in the respiratory tests were follows: oxygen — 40.0455 ± 10.83719; carbon dioxide — 31.84615 ± 6.94757; ammonia — 53.90000 ± 13.42787; endogenous alcohol — 4.80000 ± 0.421068; hydrogen sulfide — 3.966667 ± 1.318009. Indicators skin were as follows: oxygen — 9.72727 ± 3.052749; carbon dioxide — 28.65385 ± 6.273715; ammonia — 43.6000 ± 9.0942; endogenous alcohol — 4.4000 ± 0.3438; hydrogen sulfide — 3.666667 ± 0.995883. During the experiment the most correct indications of aero ionic test were recognized figures of the oxygen content (p < 0.05) and carbon dioxide (р < 0.05). This agrees with the results of study of the pO2 and pCO2 determination at Compartment syndrome. Tendencies (0,05 < p < 0,1) of increase of content of ammonia, endogenous alcohol and hydrogen sulfide, which normally should be absent, indicate as the development of syndromes of damage of kidney and liver.

Conclusions. The results of this experiment indicate the possibility of using the method of Aero Ionic tests doing the early diagnosis of Compartment syndrome on the stage of development of metabolic disorders, as well as doing the screening and monitoring of intoxication, caused by decomposition products. The Aero Ionic diagnostics, as a new noninvasive method, can be tailored to the specific clinical disciplines and may be recommended for implementation in a broad medical practice.


Bibliography

1. Reshetilov Yu.I. Zastosuvannya aeroionnoho dykhal'noho testu u diahnostytsi vnutrishnikh khvorob / Yu.I.Reshetilov, O.Yu.Vasyl'chenko, O.F.Tsapryka // Aktual'ni pytannya medychnoyi nauky ta praktyky: Zb. nauk. prats'. — Vyp. 77, T. 2, kn.1. — Zaporizhzhya, 2010. — S. 224-227

2. Reshetilov Yu.I. Aeroionna diahnostyka patolohiyi pidshlunkovoyi zalozy u spoluchenni z hastroezofaheal'noyu reflyuksnoyu khvoroboyu / Yu.I. Reshetilov, S.M. Dmytriyeva // Ukrayins'kyy zhurnal khirurhiyi. — 2011. -# 2 (11). — S . S.69-71

3.  Strafun S.S. Profilaktyka, diahnostyka ta likuvannya ishemichnykh kontraktur kysti ta stopy / S.S.Strafun, A.T.Brusko, A.P.Lyabakh, V.H.Lyeskov, S.V.Tymoshenko — K.: Stylos, 2007. — 264 s.

4. Strafun S. S. Problemy likuvannya vysokoenerhetychnykh ushkodzhen', uskladnenykh posttravmatychnoyu ishemiyeyu kintsivok / S. S. Strafun, O. V. Dolhopolov // Travma. − 2012. − T. 13, # 2. − S. 166−172.

5. King T.W. Exertional Compartmentt syndrome of the thigh: a rare diagnosis and literature review / T. W. King, O. Z . Lerman, J. J. Carter [et al.] // J. Emerg Med. — 2010. — V. 39. — P. 93–99.

6. Tiwari. A. Acute Compartmentt Syndromes / A. Tiwari. // British Journal of Oral & Maxillofacial Surgery. − 2009. — V. 4. — P. 397–412.

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