GAS DISCHARGE VISUALIZATION TECHNIQUE IN THE ESTIMATION OF FUNCTIONAL STATE OF THE ORGANISM
OPPORTUNITIES OF GAS DISCHARGE VISUALIZATION TECHNIQUE IN THE ESTIMATION OF FUNCTIONAL STATE OF THE ORGANISM IN PE-RIOPERATIVE PERIOD
Egor U. STRUKOV
ABSTRACT of thesis for the degree of Ph. D. in Medical Science
St. Petersburg 2003
Overall estimation of functional state and internal environment of the organism is very important for the treatment of patients with serious and especially acute pathogenic processes, apart from the identification of nature and character of the latter. This diagnostic approach determines the scope and effectiveness of the performed intensive therapy (B.S. Uvarov, N.A. Mezheryakov, 1974).
Large possibilities have been opened up recently in this direction, being stipulated by the successful development of clinical biochemistry and perfection of medical technique. Modern laboratory and functional methods of diagnostics allow obtaining extensive information charac-terizing the state of blood circulation, gaseous exchange, water-electrolytic and acid-base balance, system of hemostasis, function of CNS, endocrine glands, lever, kidneys, and other organs. However, apart from multiple advantages, the mentioned methods have a series of significant limitations. Particularly, a considerable part of modern laboratory and functional methods of diagnostics are not available for all patient care institutions. Furthermore, these methods demonstrate the state of particular organs and systems of the organism, or are based on using strong radiations. Certain methods have invasive character and require considerable investment and maintenance costs. Apart from that, the procedure of research, as well as the decoding of results received by means of the research require much time. Human factor might also be a cause of error on account of unequal informativeness and value of diagnostic means applied by doctors, difference in experience and knowledge.
One of the most perspective electrographic methods for the estimation of functional state of the organism is the Gas Discharge Visualization (GDV). The technique is based on the effect of registration of glow, stimulated by photons and electrons, as well as other particles near the surface of biological objects, placed in high intensity electromagnetic field. It is supposed that the biological emission enables to estimate the entropy of human state (K. Korotkov, 1995, 2000, 2001).
At present this technique is quite actively used in various spheres of medicine – therapy, oncology, obstetrics, gynaecology, and psychophysiology (Gurvitz B.L., et al., 1998; Alexan-drova R.A., et al., 1999, 2000, 2001; Azheulov A.U., 2000; Bundzen P.V., et al, 2000; Gimbut V.S., 2000; Bundzen P., Unenstahl L.E., 1999; Kolmakow S. et al., 1999). However, having analyzed literature on the topic, we haven’t found data on the application of the technique for the estimation of functional status of patients under critical state, or for the perioperative examina-tion of patients. The attractiveness of this method from the viewpoint of electrophysiology, as well as the full absence of data on the possibility of its application in the interests of anaesthesi-ology has been the basis for the performance of our research.
Aim. To estimate the informativeness of the GDV technique from the viewpoint of anaesthetist-reanimatologist during functional examination of patient in pre- and postoperative periods.
1. To prove the possibility of using GDV technique for the estimation of state of patients in need of surgical treatment.
2. To assess the value of indices, obtained with the help of GDV technique, distinguishing the most informative ones.
3. To get an idea on the position of the technique in complex preoperative examination of functional state of patients with chronic abdominal surgical pathology.
4. To investigate the possibility of application of the GDV technique for the monitoring of functional state of patient in postoperative period.
Scientific novelty. The assessment of functional state of patients with the application of GDV technique in pre- and postoperative periods.
The difference between the parameters of gas discharge images (GDI) of practically healthy people and patients with chronic abdominal surgical pathology was found.
It was revealed that the GDI indices reliably differ depending on sex, age, and the degree of severity of functional disorders.
It was proved that the GDI change in response to the operative trauma. The limits of de-viation of these indices from the preoperative indices depend on the extent and character of surgical operation, as well as on the initial functional status of the organism. Thus, the opportu-nity of using GDV technique for the estimation of intensity of operative stress was demonstrated for the first time.
The possibility of application of GDV technique for the monitoring of functional state of patients in postoperative period was disclosed. It was found that the dynamics of GDI indices in the closest postoperative period depended on the initial degree of severity of the state of patient.
The example of acute postoperative pancreatitis demonstrated prospects of application of the technique for the prediction of development of complications in early postoperative period.
Practical value. The results of the performed research demonstrate that the GDV tech-nique is a perspective method in the practice of anaesthesiology and reanimatology, which lays the basis to investigate it further. This method might be used with the purpose of evaluation of patient’s functional status in perioperative period, as well as for the identification of adequacy of organism’s response to the surgical trauma.
The dependence of GDI indices on age revealed in the course of the research indicates that it is necessary to determine the norm range for the parameters of GDV-grams of different age groups, in the course of further development of the method.
Aspects to be defended.
1. There are reliable differences between parameters of GDV-grams of practically healthy people and patients with chronic abdominal surgical pathology.
2. The obtained data indicate that GDI parameters are connected with the functional status of the organism and reflect the severity of the somatic state of patients with abdominal surgical pathology to a certain extent.
3. The most informative parameters obtained with the help of GDV technique are: “integral area of glow” in “GDV Diagram” program, “total” and “normalized area”, “total density”, “average brightness”, as well as “fractality” and “form coefficient” (“GDV Processor” program).
4. The most informative mode of registration of GDV-grams among the two applied modes is the mode “without filter”. On the whole, the application of filter keeps the trend of changes, but they are often less pronounced and unreliable.
5. The revealed variability of GDV-gram parameters depending on the sex and age of pa-tients indicates that it is necessary to determine their individual norms.
6. The dependence of perioperative dynamics of a number of indices of GDV-grams on the severity of the somatic state of patient, patient’s age and duration of surgical procedure enables using the technique for the functional monitoring in postoperative period, as well as for the evaluation of operative stress.
Materials and methods of research