Detoxification therapy - removal of toxic substances from the body. Not only those that enter the body from the external environment, but also those formed inside it can become poisonous substances. Most often, patients with alcohol poisoning, overdose of drugs, poisoning with fumes of toxic substances come to the hospital. The method for removing toxins in such patients is approximately the same. However, if the poisonous agent is released inside any organ or system, then the mechanism for conducting therapeutic measures will change somewhat.
Detoxification therapy is divided into two large groups: extracorporeal detoxification and intracorporeal. They are divided primarily in the direction of action. Intracorporeal neutralization of the body is aimed at eliminating the toxin naturally (through the excretory system). It is carried out by the introduction of antidotes of toxic substances, as well as colloidal and crystalline solutions to replenish bcc and normalize kidney function.
Extracorporeal detoxification is carried out not inside the body, but "outside", by artificially removing toxins using mechanized techniques.
Intracorporeal detoxification therapy can be carried out with the following drugs:
1. Saline solutions are used when a large amount of fluid is lost by the body. As you know, during intoxication, the emetic mechanism is most often activated to remove toxins, so patients lose a lot of fluid.
Detoxification drugs, replenishing the lost volume of liquid, are available in bottles of 200 and 400 ml. This separation was created for the convenience of introducing from the calculation of the volume of the missing body fluid.
The most commonly used drugs are:
"Disol" - sodium chloride - 600 mg, sodium citrate - 200 mg.
Ringer's solution - contains sodium, potassium, calcium and chlorine ions.
2. For intoxications with a large loss of fluid, detoxification therapy is indicated, the preparations of which contain a glucose solution. Glucose is the main energy source in the body, so for the full work of all systems it is simply necessary.
3. Colloidal solutions can be divided into synthetic and natural (natural). In practice, synthetic solutions are almost always used, they include:
- dextrans
- hydroxyethyl starch analogues
- "Gelatin"
4. Osmodiuretics are also actively used to remove toxic substances from the body. Representative: Monnitol. These drugs prevent the development of renal failure, accelerate the process of elimination of toxic substances.
5. To maintain the acid-base balance, it is necessary to use a 9% solution of sodium bicarbonate or potassium chloride.
Detoxification therapy through artificial purification of blood and other biological substrates can be carried out by the following methods:
- Hemosorption - the passage of blood through a special sorbent filter, as a result of which all toxic substances of large and medium sizes are removed.
- Plasmapheresis is the separation of blood into red blood cells and plasma. Further, the formed elements return back to the bloodstream, and the toxic plasma is replaced by an identical donor.
- Plasma sorption is a method similar to plasmapheresis, only donor plasma is not replaced, but its own is purified.
- Lymphosorption - passing lymph through a sorbent filter.
- Hemodialysis is an "artificial kidney."
- Laser and ultrasonic irradiation of blood.
Detoxification therapy with extracorporeal methods is carried out only in case of a threat to the patient's life, when other methods do not help.