Metabolic Effects of a Succinic Acid<Based Substrate Antihypoxant

The paper discusses promises for clinical use of substrate antihypoxants.Objective: to investigate the efficacy of succinate containing  substrate  antihypoxants  on  systemic  oxygen  consumption,  blood  buffer  capacity,  and  changes  in  the  mixed venous blood level of lactate when they are us...

Full description

Saved in:
Bibliographic Details
Main Authors: B. N. Shakh, V. N. Lapshin, A. G. Kyrnyshev, D. B. Smirnov, N. R. Kravchenko-Berezhnaya
Format: Article
Language:English
Published: Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia 2014-06-01
Series:Общая реаниматология
Subjects:
Online Access:https://www.reanimatology.com/rmt/article/view/1332
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849242890649206784
author B. N. Shakh
V. N. Lapshin
A. G. Kyrnyshev
D. B. Smirnov
N. R. Kravchenko-Berezhnaya
author_facet B. N. Shakh
V. N. Lapshin
A. G. Kyrnyshev
D. B. Smirnov
N. R. Kravchenko-Berezhnaya
author_sort B. N. Shakh
collection DOAJ
description The paper discusses promises for clinical use of substrate antihypoxants.Objective: to investigate the efficacy of succinate containing  substrate  antihypoxants  on  systemic  oxygen  consumption,  blood  buffer  capacity,  and  changes  in  the  mixed venous blood level of lactate when they are used in gravely sick patients and victims with marked metabolic posthypoxic disorders.Subjects and methods. The trial enrolled 30 patients and victims who had sustained an episode of severe hypoxia of mixed genesis, the severity of which was evaluated by the APACHE II scale and amounted to 23 to 30 scores with a 46 to 70.3% risk of death. The standard infusion program in this group involved the succinate-containing drug 1.5% reamberin solution  in  a  total  dose  of  800  ml.  A  comparison  group  included  15  patients  who  had  undergone  emergency  extensive surgery for abdominal diseases. 400 ml of 10% glucose solution was used as an infusion medium. Oxygen consumption (VO2ml/min) and carbon dioxide production (VCO2ml/min) were measured before infusion and monitored for 2 hours. Arterial blood gases and acid-base balance (ABB) parameters and mixed venous blood lactate levels were examined. Measurements were made before and 30 minutes after the infusion of reamberin or glucose solution.Results. Infusion of 1.5% reamberin solution was followed by a significant increase in minute oxygen consumption from 281.5±21.2 to 310.4±24.4 ml/min. CO2 production declined (on average, from 223.3±6.5 to 206.5±7.59 ml/min). During infusion of 10% glucose solution, all the patients of the comparison group showed a rise in oxygen consumption from 303.6±33.86 to 443.13±32.1 ml/min, i.e. about 1.5-fold. VCO2 changed similarly. The intravenous infusion of 800 ml of 1.5% reamberin solution raised arterial blood buffer capacity, which was reflected by changes in pH, BE, and HCO3. There was a clear trend for lactate values to drop in the mixed venous blood. The intravenous injection of 400 ml of 10% glucose solution caused no significant changes in major ABB indicators, which reinforced the statement that there is a difference in the metabolism of these substrates.Conclusion. The succinate-containing drugs are able to compensate for metabolic acidosis. Their use is followed by increased oxygen consumption  and  activated  aerobic  oxidation  processes.  The  basis  of  their  antihypoxant  properties  was  thought  to  be recovered intracellular aerobic metabolic processes due to corrected intracellular metabolic acidosis and increased blood  buffer capacity.
format Article
id doaj-art-340a5e452f104cddb3dbc624c88d2f8d
institution Kabale University
issn 1813-9779
2411-7110
language English
publishDate 2014-06-01
publisher Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
record_format Article
series Общая реаниматология
spelling doaj-art-340a5e452f104cddb3dbc624c88d2f8d2025-08-20T03:59:40ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102014-06-01101334210.15360/1813-9779-2014-1-33-421332Metabolic Effects of a Succinic Acid<Based Substrate AntihypoxantB. N. Shakh0V. N. Lapshin1A. G. Kyrnyshev2D. B. Smirnov3N. R. Kravchenko-Berezhnaya4Department of Anesthesiology and Reanimatology, I. I. Dzhanelidze Research Institute of Emergence Care, Saint Petersburg; Department of Anesthesiology and Reanimatology, Medical Faculty, Saint Petersburg State UniversityDepartment of Anesthesiology and Reanimatology, I. I. Dzhanelidze Research Institute of Emergence Care, Saint Petersburg; Department of Anesthesiology and Reanimatology, Medical Faculty, Saint Petersburg State UniversityDepartment of Anesthesiology and Reanimatology, I. I. Dzhanelidze Research Institute of Emergence Care, Saint Petersburg; Department of Anesthesiology and Reanimatology, Medical Faculty, Saint Petersburg State UniversityDepartment of Anesthesiology and Reanimatology, I. I. Dzhanelidze Research Institute of Emergence Care, Saint Petersburg; Department of Anesthesiology and Reanimatology, Medical Faculty, Saint Petersburg State UniversityDepartment of Anesthesiology and Reanimatology, I. I. Dzhanelidze Research Institute of Emergence Care, Saint Petersburg; Department of Anesthesiology and Reanimatology, Medical Faculty, Saint Petersburg State UniversityThe paper discusses promises for clinical use of substrate antihypoxants.Objective: to investigate the efficacy of succinate containing  substrate  antihypoxants  on  systemic  oxygen  consumption,  blood  buffer  capacity,  and  changes  in  the  mixed venous blood level of lactate when they are used in gravely sick patients and victims with marked metabolic posthypoxic disorders.Subjects and methods. The trial enrolled 30 patients and victims who had sustained an episode of severe hypoxia of mixed genesis, the severity of which was evaluated by the APACHE II scale and amounted to 23 to 30 scores with a 46 to 70.3% risk of death. The standard infusion program in this group involved the succinate-containing drug 1.5% reamberin solution  in  a  total  dose  of  800  ml.  A  comparison  group  included  15  patients  who  had  undergone  emergency  extensive surgery for abdominal diseases. 400 ml of 10% glucose solution was used as an infusion medium. Oxygen consumption (VO2ml/min) and carbon dioxide production (VCO2ml/min) were measured before infusion and monitored for 2 hours. Arterial blood gases and acid-base balance (ABB) parameters and mixed venous blood lactate levels were examined. Measurements were made before and 30 minutes after the infusion of reamberin or glucose solution.Results. Infusion of 1.5% reamberin solution was followed by a significant increase in minute oxygen consumption from 281.5±21.2 to 310.4±24.4 ml/min. CO2 production declined (on average, from 223.3±6.5 to 206.5±7.59 ml/min). During infusion of 10% glucose solution, all the patients of the comparison group showed a rise in oxygen consumption from 303.6±33.86 to 443.13±32.1 ml/min, i.e. about 1.5-fold. VCO2 changed similarly. The intravenous infusion of 800 ml of 1.5% reamberin solution raised arterial blood buffer capacity, which was reflected by changes in pH, BE, and HCO3. There was a clear trend for lactate values to drop in the mixed venous blood. The intravenous injection of 400 ml of 10% glucose solution caused no significant changes in major ABB indicators, which reinforced the statement that there is a difference in the metabolism of these substrates.Conclusion. The succinate-containing drugs are able to compensate for metabolic acidosis. Their use is followed by increased oxygen consumption  and  activated  aerobic  oxidation  processes.  The  basis  of  their  antihypoxant  properties  was  thought  to  be recovered intracellular aerobic metabolic processes due to corrected intracellular metabolic acidosis and increased blood  buffer capacity.https://www.reanimatology.com/rmt/article/view/1332hypoxia, reperfusion, multiple organ dysfunction, antihypoxants, metabolic acidosis, acid-base balance, lactate, oxygen consumption, succinate, fumarate
spellingShingle B. N. Shakh
V. N. Lapshin
A. G. Kyrnyshev
D. B. Smirnov
N. R. Kravchenko-Berezhnaya
Metabolic Effects of a Succinic Acid<Based Substrate Antihypoxant
Общая реаниматология
hypoxia, reperfusion, multiple organ dysfunction, antihypoxants, metabolic acidosis, acid-base balance, lactate, oxygen consumption, succinate, fumarate
title Metabolic Effects of a Succinic Acid<Based Substrate Antihypoxant
title_full Metabolic Effects of a Succinic Acid<Based Substrate Antihypoxant
title_fullStr Metabolic Effects of a Succinic Acid<Based Substrate Antihypoxant
title_full_unstemmed Metabolic Effects of a Succinic Acid<Based Substrate Antihypoxant
title_short Metabolic Effects of a Succinic Acid<Based Substrate Antihypoxant
title_sort metabolic effects of a succinic acid based substrate antihypoxant
topic hypoxia, reperfusion, multiple organ dysfunction, antihypoxants, metabolic acidosis, acid-base balance, lactate, oxygen consumption, succinate, fumarate
url https://www.reanimatology.com/rmt/article/view/1332
work_keys_str_mv AT bnshakh metaboliceffectsofasuccinicacidbasedsubstrateantihypoxant
AT vnlapshin metaboliceffectsofasuccinicacidbasedsubstrateantihypoxant
AT agkyrnyshev metaboliceffectsofasuccinicacidbasedsubstrateantihypoxant
AT dbsmirnov metaboliceffectsofasuccinicacidbasedsubstrateantihypoxant
AT nrkravchenkoberezhnaya metaboliceffectsofasuccinicacidbasedsubstrateantihypoxant