[Evaluation of clinical efficacy of serotonin adipate in treatment and prevention of enteral insufficiency syndrome at generalized peritonitis].

Aim: To substantiate pathogenetic expediency and to evaluate the clinical efficacy of the drug use serotonin adipate (dinaton) in a complex correction enteral insufficiency syndrome (EIN) in patients with generalized peritonitis (GP).
Material and Methods: The comparative analysis of results of treatment of 182 patients with GP, which in principle approach to EIN correction in the postoperative period were divided into two groups. Group I consisted of 92 patients who received standard intensive therapy using conventional methods of stimulation of intestinal peristalsis. Group II consisted of 90 patients on a background of standard treatment was carried further pharmacological stimulation of intestinal motility drug serotonin adipate (dinaton). The research program included an assessment of clinical parameters intestinal motility recovery, evaluation of the severity of the patients on a scale of APACHE II, determining the blood levels of serotonin and the level of the main biomarkers of systemic inflammatory response (SIR), the study of blood flow in the vessels of splanchnic bed, the measurement of intra-abdominal pressure with the calculation of intraperitoneal perfusion pressure.
Results: It is found that the development and progression of abdominal inflammation is accompanied by a sharp decrease in blood serotonin level is in phase III GP decreases 4.7 times compared to the control value. It is shown that using of serotonin adipate (dinaton) in treatment of patients with GP promotes early recovery of intestinal motility and the resolution of EIN, the elimination of intra-abdominal hypertension and disorders of splanchnic blood flow, as well as the rapid regression of the manifestations of the SIR and endotoxemia. Postoperative mortality in group I patients was 28.3% in group II - 20.0%.
Conclusion: The inclusion of serotonin adipate (dinaton) in the complex corrective therapy standard in the postoperative period in GP patients is pathogenetically justified, as it promotes early restoration of motor activity of the gastrointestinal tract, the elimination of intestinal paresis and resolution of EIN, which leads to an improvement of results of surgical treatment of this patients.