RU-2861460-C1 - METHOD OF USING RADIOPAQUE AGENT FOR DIAGNOSIS AND TREATMENT OF OBSTRUCTIVE INTESTINAL OBSTRUCTION IN NEWBORNS AND PREMATURE INFANTS

Abstract

FIELD: medicine; pharmaceuticals. SUBSTANCE: invention relates to a method of using a radiopaque agent for the diagnosis and treatment of obstructive intestinal obstruction in newborns and premature infants. The method of using a radiopaque agent for the diagnosis and treatment of obstructive intestinal obstruction in newborns and premature infants consists of administering the agent through a gastric tube, wherein an agent based on an aqueous solution of iopromide is used, containing resistant starch: iopromide 20 ml, distilled water 40 ml, potato starch 2 g, administration is carried out at a dose of 10 ml per 1 kg of the patient's body weight, and the agent before administration is at room temperature. EFFECT: visualisation of soft tissues during X-ray examination and during its movement through the gastrointestinal tract has a low risk of side effects and does not cause homeostasis disorders in newborns, which increases its effectiveness in the diagnosis and treatment of obstructive intestinal obstruction in newborns and premature infants. 1 cl, 8 dwg

Inventors

• Shvalev Fedor Mikhajlovich
• TSAP NATALYA ALEKSANDROVNA
• Chudakov Vladislav Borisovich
• Shibanova Oksana Aleksandrovna
• Suenkova Darya Dmitrievna

Dates

Publication Date

20260505

Application Date

20241111

Claims (1)

1. A method for using a radiocontrast agent for the diagnosis and treatment of obstructive intestinal obstruction in newborns and premature infants, consisting of administering the agent through a gastric tube, characterized in that the agent used is based on an aqueous solution of iopromide containing resistant starch: iopromide 20 ml, distilled water 40 ml, potato starch 2 g, while the administration is carried out at a dose of 10 ml per 1 kg of the patient's body weight, and the agent is at room temperature before administration.

Description

The invention relates to medicine, in particular to pediatric surgery, namely to the diagnosis and treatment of gastrointestinal obstruction in newborns and premature babies to assess the level of obstruction and normalize intestinal function. A method for producing and using a barium sulfate mixture [1] is known. This mixture consists of insoluble barium sulfate powder mixed with water to create a suspension that is not absorbed from the gastrointestinal tract, has fewer complications, does not enter the systemic circulation, and is eliminated naturally. It offers high contrast and image quality due to its high density. However, this method has limitations in cases of suspected gastrointestinal (GI) perforation: during perforation, the barium suspension can cause severe inflammation and trigger adhesions. This method is also not recommended for suspected obstructive intestinal obstruction, due to the potential for worsening the condition or provoking intestinal obstruction. Therefore, this method cannot be used in premature and newborn infants with intestinal hypomotility or a small intestinal lumen due to the risk of barium retention due to hardening in the intestinal lumen, leading to obstruction. Its use in newborns and premature infants has not yet been fully studied. A method for diagnosing and treating intestinal obstruction using the water-soluble contrast agent Gastrografin is known [2]. However, this method has serious drawbacks that limit its use in premature and newborn infants. Complications include intestinal perforation, rapid elimination of the contrast agent from the intestine through renal filtration, osmolar diarrhea, dehydration, hypovolemic shock, and electrolyte disturbances. Intraintestinal administration of the water-soluble contrast agent iopromide without the addition of starch is known [3]. When administered, iopromide ensures uniform distribution of the contrast agent throughout the body, is less toxic, and has fewer side effects. However, this method has significant drawbacks, including slow transit and rapid absorption of the contrast agent by the intestinal wall, followed by renal filtration. In young healthy volunteers, 97% of the dose is eliminated unchanged in the urine and 2% in the feces. This may increase the risk of kidney damage, especially in patients with pre-existing kidney disease. The objective of the claimed invention is to develop a method for using a radiopaque mixture with the addition of resistant starch, which allows for a safe and minimally invasive assessment of the degree of gastrointestinal tract patency, stimulating intestinal motility, which will improve the results of immediate and long-term treatment of newborns and premature infants with intestinal obstruction. The closest prototype of the claimed method is the method for preparing and using Gastrografin solution, as described in the drug's instructions [4]. The oral dosage for infants and children under 5 years is typically 30 ml (11 g iodine). If necessary, the solution can be diluted 1:1 with saline or water. However, despite its relative effectiveness, this method has significant drawbacks: 1. The use of Gastrografin can cause significant disturbances in water-electrolyte balance due to its hyperosmolarity, which is especially dangerous for premature infants with immature regulatory mechanisms. 2. The need for preliminary correction of water and electrolyte imbalances before using the drug complicates the procedure and may delay the start of treatment in critical situations. 3. If Gastrografin is retained in the gastrointestinal tract for a long time, for example, due to obstruction or congestion, the risk of tissue damage, bleeding, necrosis and intestinal perforation increases, which is especially dangerous for premature infants with an immature intestinal wall. Thus, despite its widespread use, the existing method has significant limitations and risks, especially when used in premature infants with obstructive intestinal obstruction. This necessitates the development of a new, safer, and more effective method for diagnosing and treating this condition. The invention is aimed at optimizing the safety and effectiveness of diagnosing and treating obstructive intestinal obstruction in premature infants through the use of a drug obtained by modifying iopromide with resistant starch. Standard radiocontrast agents already exhibit high aqueous solubility, low binding to biological receptors, low toxicity, and high biocompatibility. The use of mixtures containing resistant starch can further improve certain properties, such as viscosity, contrast, residence time in the body, and unchanged excretion through natural processes. Resistant starch (RS) is a unique form of carbohydrate that, unlike most starches, is resistant to enzymatic breakdown in the upper gastrointestinal tract [6]. This property prevents it from being transformed into simple sugars and subsequently absorbed in the small intestine. As