The Use of Selective Hemosorption of Lipopolysaccharides in the Complex Treatment of Sepsis
| Autor: | G. V. Bulava, S. I. Rey, G. A. Berdnikov, O. V. Nikitina, A. K. Shabanov, N. V. Borovkova, N. N. Salina, M. A. Godkov |
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| Jazyk: | ruština |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Неотложная медицинская помощь, Vol 9, Iss 2, Pp 201-209 (2020) |
| Druh dokumentu: | article |
| ISSN: | 2223-9022 2541-8017 |
| DOI: | 10.23934/2223-9022-2020-9-2-201-209 |
| Popis: | Background Sepsis and septic shock are formidable and complications in surgery with mortality 20–50%. In the pathogenesis of sepsis, a significant role belongs to bacterial endotoxin (LPS - liposaccharide).Aim of study Assessment of the efficacy of selective lipopolysaccharides hemosorption (SLH) in treatment of sepsis.Material and methods We examined 65 patients with developed sepsis or suspected presence of gram-negative infection. Patients were retrospectively divided into two groups. In Group 1, 27 patients received Polymyxin B hemoperfusion using Toraymyxin cartridges. In Group 2 (38 patients), adsorber Alteco (LPSA) was used.Results It was established that 28-day mortality was 11.1% in Polymyxin group and 28.9% in LPS group A, p = 0.091, 60-day mortality was 33.3 and 55.3%, respectively (p=0.065). The use of SLH contributed to a decrease in the activity of endotoxin (EAA) from 0.52 (0.39; 0.65) to 0.40 (0.36; 0.57) EU (p=0.330) in Polymyxin group and from 0.59 ( 0.42; 0.72) to 0.54 (0.40; 0.81) EU ( p = 0.981) in the LPS-A group. At the same time, the level of procalcitonin (PCT) in the blood statistically significantly decreased from 8.4 (3.6; 29.0) to 4.8 (1.9; 36.3) ng/ml (p=0.0117) only in the LPS-A group. The level of C-reactive protein (CRB) in the blood statistically significantly decreased only in the Polymyxin group, from 205 (154; 264) to 162 (106; 202) mg/L (p |
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