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Children with acute pneumonia in the presence of hypotrophy derive no benefit from conventional therapy, with no change for the better being noted in the degree of endogenous intoxication. Endotoxemia has been shown to be alleviated by endovascular laser irradiation of blood included in the complex of therapeutic means of remediation used in acute pneumonia against the background of hypotrophy, which fact permits reducing the volume of medicamentous therapy. The above treatment option has also been found to exert a beneficial effect on the course of the illness.

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The results of complex treatment of 81 patients with pyoinflammatory diseases with the use of blood ultraviolet irradiation are discussed. A marked clinical effect was noted, the terms of treatment reduced by 5-10 days, the outcomes improved, and the number of complications decreased. Irradiation of autologous blood by ultraviolet rays led to modulation of the indices of antimicrobial protection, increase of the intensity of the histochemical reaction to peroxidase up to 40-50%, and diminution of pH in the neutrophil phagosomes to 5.0. The ultrastructure and ability of thrombocytes to store serotonin were restored, and intensity of their metabolic processes increased, the membrane phospholipid composition changed, and juvenile platelet forms appeared.

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The use of the method of autologous blood photomodification in surgery is discussed on basis of generalized experience of the Leningrad Research-Practical Center of Blood Photomodification (3,000 procedures conducted in over 2,000 patients). The current state of the problem, the main mechanisms of the therapeutic action of the procedure, and the clinical efficacy of the method in various surgical diseases are dealt with. The possible complications and the means of their prevention are deal with. The methodological aspects of research are discussed. The authors define the main problems which must be solved in order to raise the efficacy of using photomodification of autologous blood in surgery.

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Changes in the values of the immune status during UV autohemotherapy were studied in 22 patients with surgical endotoxicosis of various genesis. Maximum tension of immunogenesis was found in all patients. The time course of changes in the general pool of rosette-forming and separate populations of neutrophils, as well as in the index of immunocompetent cell ratios are evidence of the high informativeness of these tests in determining the severity of the immune system dysfunctions.

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The intravascular laser irradiation of blood which was used in treatment of 100 patients decreases the level of endogenous intoxication, stimulates the defensive forces of the organism, improves the condition of the patient, contributes to quicker recovery and may be actively used in treatment of patients with a surgical infection.

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Experimental (118 experiments) and clinical (30 patients) investigations have shown a positive effect of endovascular irradiation of blood with the helium-neon and ultraviolet lasers on recovery of homeostasis in pancreatitis and peritonitis. The procedure stimulates the erythrocyte bioenergetics, reduces the degree of haemic hypoxia and increases nonspecific immunological reactivity.

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Acute hypoxia is known to cause a marked reduction in intestinal and peripheral blood flow, in favor of blood flow to the brain and heart. Complete occlusion of the intestinal circulation is known to damage the gut wall, allowing potentially lethal endotoxins present within the intestines to escape into the circulation. We examined here whether the breathing of a hypoxic gas mixture could lead to sufficient damage of the intestinal wall to cause endotoxemia. Six anesthetized monkeys breathed air for 1 hr, then an hypoxic mixture (FIO2 = 0.13) containing N2O for 1 h and, finally, 100% O2. Plasma endotoxin concentrations were determined by two methods. After approximately 40 min of hypoxia, the plasma endotoxin level rose significantly from 0.39 to 1.60 ng X ml-1 (p less than 0.001) and then subsided to near control levels. Control monkeys breathing air only or 70% N2O in oxygen (FIO2 = 0.3) for 3 h showed no such elevation in plasma endotoxin concentration. We conclude that hypoxia leads to a temporary endotoxemia in primates. Reticuloendothelial system depression by whole body X-irradiation (200 rads) increased both the magnitude and duration of the hypoxia-induced endotoxemia. Prior administration of equine anti-lipopolysaccharide (anti-LPS) hyperimmune plasma greatly reduced the magnitude of the induced endotoxemia. Since endotoxemia may be lethal, the use of anti-LPS as possible prophylaxis should be considered in persons breathing artificial atmospheres or where acute hypoxia may be a danger.

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