Biochemical and pathogenetic mechanisms in off label carboxytherapy in respiratory failure

Abstract

Carboxytherapy is an alternative method of pharmacotherapy, a modern off label method. The term "off label use" was given by the US Food and Drug Administration in 1997. The use of off -label drugs expands the possibilities of pharmacotherapy, sometimes when nothing else meets the patient's needs or when the doctor is sure that the off-label drug in the on-label complex (according to the instructions) increases the effectiveness and safety of pharmacotherapy. Due to the antihypoxic, antioxidant and anti-inflammatory properties of CO2: carboxytherapy is an effective off label treatment for respiratory failure. CO2 as a natural stimulator of respiration consists in the fact that at the slightest change in its concentration (by 0.1%), various natural mechanisms of a rapid return of the CO2 level to the physiological norm are activated. In this effect of CO2, an important biochemical and physiological role is played by central respiratory chemoreception, a mechanism by which an increase in pC promotes the stimulation of the act of respiration. A similar mechanism of respiratory stimulation is metabolic acidosis (blood acidification at normal CO2 levels). Under hypoxia, the effect of CO2 on O2 consumption is paradoxical: with O2 deficiency with an increase in the CO2 concentration in the tissues, it should aggravate the hypoxic state, but in reality, under the action of carboxytherapy during hypoxia, an increase in CO2 concentration enhances the tissue oxygenation process, since CO2 is one of the most powerful natural stimulants of the respiratory center, and it also releases O2 from oxyhemoglobin (Verigo-Bohr effect). Biochemical and pathogenetic mechanisms of CO2 action on the respiratory center are realized in two complementary ways: direct action - an increase in the concentration of CO2 in the blood affects the central chemoreceptors of the medulla oblongata, reflex - through vascular reflexogenic zones (peripheral chemoreceptors). Through these mechanisms of respiration regulation, under the influence of CO2, the structure of the respiratory reflex changes (respiration deepens and its frequency decreases), as a result of which the minute volume of pulmonary ventilation increases by 1 -1.5 l / min. Compensatory enhancement of O2 diffusion in the lungs leads to an increase in the oxygen content in the blood and an increase in its delivery to tissues. In diseases of the respiratory system, carboxytherapy helps to reduce pathological symptom complexes of chronic and spastic bronchitis, bronchial asthma, pneumosclerosis, pulmonary emphysema, silicosis due to the biochemical and pathogenetic properties of CO2, providing antihypoxic, antioxidant, anti-inflammatory, antispasmodic, antiseptic and analgesic effects.