Endogenous intoxication

(autointoxication) is a syndrome typical of many pathologic processes and conditions due to a massive arrival of various toxins into the bodys internal environment.

 In normal conditions the immune system recognizes foreign bodies, fixes them with antigen-antibody-complement complexes, detains them in lymphoid tissue, subjects to phagocytosis and destruction by lysosomal enzymes. he liver and intestine inactivate a great amount of liposoluble toxic substances which under the impact of chemical reactions convert to hydrophilic ones and are excreted by kidneys. The lungs eliminate carbon dioxide, water, volatile toxic substances, and metabolic products of aggressive fluids.

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 constitutes the foundation of prognosis: in insufficiency of one organ or system mortality is about 23-40%; of two organs or systems 53-60%, three and more 73-89%.

Forced diuresis
is used when the patient receives diuretics after infusion of a large amount of fluid (3-5 litres).

The mechanism of action of detoxication 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).

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 on drugs.

In their relation to the bodys own detoxication system nonmedicamentous methods are divided in the following way:
Methods enhancing the processes of natural cleansing. Artificial detoxication, the possibility of temporary replacement of disrupted functions. Special antidote therapy.

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 poisoning with substances excreted through the lungs) therapeutic hyperthermia and hypothermia (sauna for stimulation of metabolism, therapeutic pyrogens; hypothermia as prevention of hypoxic intoxication in surgery with replaced circulation. hyperbaric oxygenation.

Artificial detoxication 1. Afferent methods (based on mechanical

removal of toxins together with blood components and subsequent dilution of blood).

Blood substitution (exchange transfusion in newborn babies with hemolytic anemia). Plasmapheresis (discrete and continuous). Drainage of thoracic lymph duct and all types of lymph outflow stimulation.

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 pores permeable to only water and electrolytes (in fluid retention, anasarca, eclampsia)

3. Sorption methods based on using

sorbents, substances that fix toxins. Most often it is sorbents consisting of active carbon.
Extracorporeal sorption (hemosorption, plasmasorption, lymphosorption, liquisorption). Enterosorptrion, intracorporeal method. The sorbents are active carbon, polyphepam, enterosgel (natural sorbents are bran and cellulose). This method fixes toxins formed in the intestine after arrival there from blood (up to 12 litres of fluid secreted in the body passes through the intestine a day). Vulneosorption, local method. Special sorbents (emosgent) or dressings of fabrics based on carbon fibres are used.

4. Electrochemical methods are based

on electrolysis of solutions and subsequent oxidation of toxins.
Electrolytic oxidation. Indirect electrochemical oxidation is possible. Electrolysis yields an unstable solution which upon passing to blood stream releases active oxygen which oxidizes the toxins. For instance sodium hypochlorite can be used: NaCl NaClO which then breaks down to NaCl and O2. Ozone therapy and ozonation of solutions. O2 + O = O3. The saturated O3 solution is transfused to the patient, in the blood stream O3 breaks down and the released active oxygen oxidizes the toxins. O3enriched solution can be used for management of wounds.

5. Quantum therapy (physiohemotherapy,

irradiation or photomodification of blood). The detoxicating effect of these methods is not very pronounced. It is mostly brought about by the immune system indirectly.
Ultraviolet radiation of blood. Many methods of ultraviolet radiation of blood have been proposed. The first ones consisted in irradiating blood drawn into a vial with bactericidal lamps. Then the continuous-flow method was developed when the blood was irradiated flowing through a tube of quartz glass. The main question in any method is the choice of optimum radiation dose as an overdose causes a condition like excessive sun exposure in spring.

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 the tissues and stimulating physical and chemical processes in organs and tissues. Thus blood acts as a carrier of photon energy. Physical and chemical processes in the tissues are as follows: a change of energetic activity of biological membranes, conformation changes of molecules, formation of photolysis products. This induces biological response of tissues: inflammation stages become shorter, edema reduces, oxygen consumption by tissues increases, blood flow gets faster, rheological properties of blood improve etc.

is a still more complicated question. The laser beam is different from light in that it is monochromatic and coherent.

Laser irradiation

Laser irradiation can be different:

1.According to the wavelength and the source of laser energy.
In UV part of spectrum CO2 lasers irradiate In the visible part of spectrum ruby, sapphire, helium-neon lasers, cuprum-vapour laser. In the infrared part gallium arsenide lasers work.

2.According to their capacity:

High energy surgical lasers (flux >10 Watt/cm) cut tissues and are used in surgery Medium energy lasers coagulate and evaporate tissues (flux 0.4 10 watt/cm) Low energy (therapeutic) lasers are used for blood irradiation.

Laser irradiation can be different (continue):

3. According to the continuity of irradiation
Continuous ad impulse lasers

4. According to their focus focused and unfocused lasers.

For detoxication and immunostimulation purposes low energy lasers are often used; they operate in the visible and infrared part of the spectrum.

5. The methods of magnetotherapy and membrane oxygenation of blood stand somewhat apart.
However, considering that they are mostly used in combination with efferent methods we should discuss them as well.