“Reach the cells”: microcirculatory support

Abstract

Background. Vessels of the microcirculatory tract provide regulatory, drainage, thermocontrol and signal functions. Disorders of these vessels are the part of the pathogenesis of coronary heart disease, endarteritis obliterans, Raynaud’s disease, etc. Common causes of microcirculation disorders include disorders of central and regional blood circulation, impaired blood volume and viscosity, impaired permeability of microvessel walls. Objective. To describe the features of microcirculatory support. Materials and methods. Analysis of literature sources on this topic. Results and discussion. In order to improve microcirculation, various drugs are used: antiplatelets, anticoagulants, antioxidants, and nitric oxide donors. The purpose of these drugs are to improve the rheological properties of blood, to improve the delivery of nutrients to the vascular wall, to regulate the vascular tone, and to improve endothelial function. Reosorbilact (“Yuria-Pharm”) opens precapillary sphincters, increases the area of blood contact with the target cell, improves tissue oxygenation and rheological properties of blood. Reosorbilact includes such components as sorbitol, basic cations (Na, Ca, K, Mg) and sodium lactate. Sorbitol is used for urgent energy needs, metabolized and stored as glycogen, has a disaggregating effect, improves microcirculation and tissue perfusion. The hyperosmolar action of Reosorbilact is to stimulate the flow of fluid from the intercellular space into the vascular bed. Correction of metabolic acidosis with Reosorbilact is slower than due to sodium bicarbonate buffer, so this solution does not cause severe fluctuations in pH. The detoxifying effect of Reosorbilact involves washing of metabolites and toxins out from damaged cells, tissues and organs, followed by their rapid excretion due to increased diuresis. The improvement of liver microcirculation and replenishment of glycogen depot, which normalizes the functional state of hepatocytes and enhances physiological detoxification, is an additional beneficial effect. Hemodilution is also important, because it allows to reduce the content of toxic metabolites in blood plasma. In addition, Reosorbilact gently stimulates peristalsis, has choleretic and cholekinetic effects, reduces bilirubin and creatinine, improves energy metabolism, stabilizes systemic hemodynamics, reduces the symptoms of pain due to anti-edematous effect, and accelerates wound healing. Reosorbilact can be considered a drug № 1 for low-volume infusion therapy. The positive hemodynamic effect of the drug is manifested within 2-3 hours. Reosorbilact promotes the transition of the hypokinetic type of blood circulation into eukinetic due to the redistribution of extracellular fluid into the vascular bed. The drug should be prescribed at a dose of 7 ml/kg of body weight for 5-7 days or until the symptoms of intoxication are reduced. Conclusions. 1. Vessels of the microcirculatory tract provide regulatory, drainage, thermoregulatory and signal functions. 2. Common causes of microcirculation disorders include disorders of central and regional blood circulation, disorders of blood volume and viscosity, impaired permeability of microvessel walls. 3. Reosorbilact improves tissue oxygenation and rheological properties of blood, promotes washing of metabolites and toxins out from damaged cells, normalizes the functional state of hepatocytes, stimulates peristalsis, stabilizes systemic hemodynamics.