Abstract
<jats:p>Background. Studies on the mechanisms of metabolic syndrome formation under the influence of low temperatures, the pathogenesis of necrosis, cellular and molecular mechanisms of inflammation in widespread local and severe general cold injury require further research. The purpose of the work was to identify clinical and experimental parallels between general and local cold injury and to clarify the pathogenesis and mechanisms of cold illness formation, taking into account systemic anti-inflammatory response syndromes. Materials and methods. Experimental studies were conducted on six-month-old white Wistar rats weighing 250–270 g, as well as on four-month-old Chinchilla rabbits weighing 2000–2100 g, in accordance with the provisions of the European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes. A total of 80 rats and 20 rabbits were involved. The experiments were conducted using intramuscular ketamine anesthesia. Clinical studies included observations of 712 patients with general and local cold injury aged 21 to 77 years. The control group consisted of 30 practically healthy individuals aged 20 to 65 years. Results. Pathohistological and histochemical studies in animals, and the results of thanatological studies (56 deceased people) revealed certain signs of the damaging effect of cold on internal organs in case of general cold injury and widespread local lesions, which led to the formation of multiple organ failure and death. Significant disturbances in microcirculation and oxygen transport function of erythrocytes were detected with impaired oxygen utilization, which subsequently led to dysfunction of internal organs and the development of multiple organ failure syndrome. The causes of mortality in those who died from cold injury indicate an insufficient assessment of the damaging effects of cold in the early stages of the injury when using traditional cold injury treatment technology. Conclusions. The results obtained indicate that development of metabolic syndrome of systemic inflammatory response with severe general hypothermia of the body combined with trauma and widespread local damage by low temperatures, with pathological changes in organs and systems, should be considered as manifestations of cold illness. In the dynamics of its pathogenesis and clinical course, stages of shock, toxemia, septic toxemia, septic complications in the form of multiple organ dysfunction syndrome, multiple organ failure syndrome, and sepsis can be identified.</jats:p>