To create a safe way to the overall hyperthermia, we assumed a total of thermodynamics and heat stress on the body. The figure presents options for general heating body, which proposes to develop our version of the total peak hyperthermia (Figure 1) to heat stress on the body 5-6 times smaller than the well-known, used worldwide
In order to establish a protocol, using the method (PG), a thermal uniform treatment 30 HIV-infected patients. Shown the safety of this technique. The effectiveness as measured by changes in the level of CD4 + lymphocytes and viral load in the blood.
Description of PG
Under the scheme of treatment a patient three procedures hyperthermia peak at a frequency of 1 every 3-4 days, after which the patient is on outpatient observation for a period of 2 months, then be 4-I procedure.
The procedure peak hyperthermia is carried out under total intravenous anesthesia with myoplegia and high Ventilator pure oxygen.
For 2 days before the procedure, the patient is held pre procedure training methene (10 mg / kg 3 times a day per os). A standard fluid preparation (Sol. NaCl 0,9% - 400,0 ml + Sol. Trentali 5,0 ml, Sol.Glucosae 10% - 400,0 ml + Sol. KCl 4% - 30,0 ml + Sol. MgSO4 25% - 5,0 ml + Sol. Insulin 6 pcs.) is purifying enema.
The morning of the procedure is repeated fluid preparation (Sol. NaCl 0,9% - 400,0 ml + Sol. Trentali 5,0 ml, Sol. Glucose 10% - 400,0 ml + Sol. KCl 4% - 30,0 ml + Sol. MgSO4 25% - 5,0 ml + Sol. Insulin 6 pcs.)
After induction anesthesia and the introduction of muscle relaxants patient to intubate, transferred to the HIV IVL installed sensor sensitive 0,05 ° C (Ist and IInd trimester - in the middle third of esophagus, III-s - in the course of the bow) temperature recorded the maximum of testimony. If it’s necessary, organize set nasogastric probe. After anesthesia patient into the bathtub with water (water temperature 45 - 45,5 ° C). After a period of adaptation (1-2 minutes) begin warming the patient's immersion-convection way. Gradually, the water temperature brought to 46 - 46,5 ° C. During the procedure, the patient entered migraine & other episodic disorders and metabolic drugs. For 15-20 minutes the patient's body temperature brought to 43 - 43,5 ° C and warming stops. We establish a urinary catheter, a fluid therapy to correct volumeter disorders. Cooling the patient is happening passively for 30 - 50 minutes.
During the warm blood pressure is controlled with a period of 30-45 seconds, with continuous monitoring heart rate. (AD allowed to systolic blood pressure - 140 - 200 mm RT. Art., Diastolic blood pressure - 80 - 0 mm RT. Art., HR> 120 per minute, <170> 50 ml / h. After the procedure, the patient may experience nausea and vomiting.
All the time between procedures, the patient must take methene (10 mg / kg 3 times a day per os).
Safety of PG
It held 120 procedures peak hyperthermia from 30 patients suffering from HIV infection stage III and IVA (classification V. Pokrovsky).
Phase III diagnosed among 87% of patients (26 people), stage IVA from 13% (4).
Average time warming, the maximum temperature, cooling time and overall time Ventilator, when (PG) in HIV - infected patients.
Time warming n = 120 n = maximum temperature of 120 cooling time n = 120 Total IVL n = 120
17 ± 1 min 43,4 ± 0,2 o 16 ± 2 min 46 ± 4 min
Compare the clinical and biochemical indicators in the first procedure, the first day after the third procedure and the second day after the fourth procedure peak hyperthermia. R-graph of light and ECG did not identify any changes, as compared to baseline.
Trased with overall target Conducted to assess the overall security procedures for monitoring the peak hyperthermia major hematological indicators: the content of erythrocytes, hemoglobin, white blood cells, differential, platelets and SOE has not identified significant changes. In the overall analysis of urine to climb on the same points, pathology has been identified
After 3 procedures peak hyperthermia, with 12 people a decline in viral load at 1 - 40%, from 18 people - 60 - 99% from baseline (Fig.3).
As shown in Figure 4, after the 4th procedure peak hyperthermia, 90% of patients viral load dropped by more than 91% of the original values, while 10% of patients have reduced vermin from 70 to 90%.
There is reason to believe that the peak hyperthermia not only stimulates immunity, but also has a direct effect viral that justifies its use in the treatment of HIV infection.
Reduced viral load and increased immunity to allow prophylaxis progression of the disease in HIV-infected patients, and possibly the development of immunodeficiency (AIDS).
Contraindications to the use of PG
1. Intolerance of drugs used for the peak hyperthermia.
2. Organ violations and lack of function of vital organs.
3. Changes in clinical and biochemical indicators:
- Leucocytes <3> 10 * 10 ^ 9 / L, platelets <150>
- The level of bilirubin, ALT, AST greater than 2-fold rule;
- The level of urea, creatinine increased more than 10% of the border rules.
4. HIV - the infection stage IVB, IVV, V.
5. Pregnancy.