The main sources of vitamin E are foods such as bread made from wheat flour, pulses, meat, fish, by-products, yeast, vegetable oil, eggs, cereals, dried mushrooms, peanuts, vegetables (potatoes, tomatoes, green peas, sweet peppers). Vitamin C (ascorbic acid) has its own specific features that are manifested in the fact that he is involved in many physiological and biochemical reactions (promotes tissue regeneration, provides resistance to stress, provides a normal immune system and hematologic status, promotes the assimilation of iron, protein, vitamins, lowers cholesterol in the blood and eliminates the effect of allergens and carcinogens, increases resistance to adverse environmental influences and infections). Vitamin C plays a major role in the synthesis of collagen, which is one of the components of the blood vessels. The main causes of hypovitaminosis C are domestic factors (heat and cook processing of products of vegetable origin), improper and prolonged storage of food, cooking in the presence of salt, iron and copper. In partial lack of vitamin C in daily diet has been a general fast fatigue, sleepiness, decreased performance, swelling and bleeding of the gums, rough skin. In marked hypovitaminosis C is characterized by cyanosis of lips, nose, ears, nails, bulk and bleeding gums, hypochromic anemia, pallor, dry skin, etc. The highest amount of vitamin C found in fresh vegetables, fruits and berries (rosehips, black currant, sea buckthorn, red pepper, citrus, parsley, cabbage, potatoes, etc.), and also integrated in multivitamin preparations. Body's need for vitamins better variety of food consumption is met.
Supplementation of multivitamins and mineral supplements should be moderate, and dose – Individual. It all depends on diet, lifestyle and other factors. It is advisable to consume multivitamin preparations under conditions of limited food intake (vegetarian, strict diets for weight loss), as well as women of childbearing age, those who are rarely in the open air (disabled, elderly, people with chronic diseases), in violation of digestion, the population living in ecologically unfavorable conditions. Not should we forget that in some cases, vitamin supplements, especially its excess, could adversely affect the human body. For example, excess vitamin A leads to liver damage, drowsiness, itchy skin, hair loss, etc. Especially dangerous for pregnant women overdose. Long-term (several months), excessive intake of vitamin D and calcium metabolism breaks as a result – causing kidney disease. Excess vitamin E leads to bleeding when taking medications that reduce blood clotting.
Abuse of vitamin C leads to diarrhea, blood clots or the formation of kidney stones. It should not be Vitamin B6 is also abused because of the danger of damage to the nervous system. To assess the availability of these vitamins, the body must turn to the appropriate specialist. Often biomaterial for identification of hypervitaminosis a urine and blood, as well as conducting various tests.
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In this situation, we must carefully change the location of the catheter, pull it toward you, and to make follow-HS volume of circulating fluid. During the operation it is necessary to closely monitor the patient (subjective feeling, heart rate, blood pressure, BH skin condition, behavior). If you experience any complications (fever, hypotension, bleeding, etc.) to try to remove them without stopping the HS. Along with heparin in arterial line during HS infusion administered at a dose of 1.5-2.0 trental mg / kg in 500 ml of saline solution, and if necessary being symptomatic therapy. We should not make attempts rastrombirovaniya sorbent during HS saline as possible hemolysis. Silicone and PVC line is not recommended needle. Injections should be made through a special lock or a rubber segment. With some experience in the operation hemosorption easy to implement and is safe for the patient.
High biocompatibility biospecific sorbents virtually eliminates complications associated with connecting the extracorporeal circuit with a sorbent to vascular system of the patient. Reduced to a minimum the possibility of anafilaticheskih reactions, pulmonary edema, metabolic disorders, which are described for a number of dialysis membranes and some natural sorbents first generation. Complications of HS using a sorbent of this type can be associated mainly with the technique or methodological errors of the operation. 1. Complications due to technical errors: o defects in the catheterization of central and peripheral blood vessels; o depressurization perfusion system that untimely identification can cause significant blood loss; o occurrence air embolism in displacement of blood from massoobmennika air, in the process itself is a complication of HS may occur during veno-venous connection option when silicone tube slips out from under the roller pump, or lack of proper supervision by medical staff during the displacement of blood with air; o the risk of infection in patients with non-compliance with GS rules of asepsis and antisepsis. 2.
Complications associated with inadequacy of the methodology of the GS: o chills – the most frequent and quite serious complication of HS. Chills associated with pyrogenic reactions due to poor cleaning of the sorbent or pyrogenicity transfuznyh environments, rather easily cropped. There is also evidence of the role of large doses of heparin in the occurrence of this complication. Massive lipolysis induced by heparin superdozami, leading to consumption of calcium may be the reason for this; o collaptoid reaction – a common cause of this complication is hypovolemia and circulatory centralization. Sorption of vasoactive peptides with pressor leads to decentralization and circulatory hypotension; o massoobmennika thrombosis and extracorporeal systems are most commonly associated with the difficulty of correcting the system of regulation the state of aggregation of blood when not in use opportunities to influence the components of this complex system and for the prevention of thrombotic events only apply large doses of heparin. It should also be noted that it was in septic disease is sharply reduced primary target of action of heparin – antithrombin-III. So large doses of heparin does not facilitate the perfusion, but rather the contrary, contribute to the development of adverse reactions of heparin.
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