ПОЛИМИКСИН-ПРИШИТЫЙ СОРБЕНТ В ЛЕЧЕНИИ ПАЦИЕНТОВ С СЕПТИЧЕСКИМ ШОКОМ

ABSTRACT. The key component of the sepsis pathogenesis is the gram-negative bacteria endotoxin. It is a lipopolysaccharide of the bacterial wall, which circulation in the bloodstream results in unlimited activation of some biological systems, causing serious complications. Nowadays, there are developed and practiced sorption methods, based on the selective removal of the lipopolysaccharide from the blood during perfusion through the sorption column with covalently immobilized polymyxin on a bioinert matrix, which can bind and inactivate it. The therapeutic effect of hemosorption using the biospecific antilipopolysaccharide hemosorbent has been studied in patients with septic shock, associated with peritonitis and septic complications of destructive pancreatitis. РЕЗЮМЕ. Ключевым звеном патогенеза сепсиса является эндотоксин грамотрицательной бактерии. Он представляет собой липополисахарид (ЛПС) бактериальной стенки, в результате циркуляции которого в кровяном русле происходит нелимитированная активация ряда биологических систем, что обуславливает возникновение тяжелых осложнений. В настоящее время разработаны и используются сорбционные методы, которые основаны на избирательном удалении ЛПС из крови при перфузии ее через сорбционную колонку с ковалентно иммобилизированным на биоинертной матрице полимиксином, который способен связывать и инактивировать его. Характер лечебного действия гемосорбции на биоспецифическом антилипополисахаридном гемосорбенте был изучен в группе пациентов с септическим шоком, который развивался на почве гнойного перитонита и гнойных осложнений деструктивного панкреатита.

БИОСПЕЦИФИЧЕСКИЕ ГЕМОСОРБЕНТЫ. УСПЕХИ И ПРОБЛЕМЫ

Understanding the leading role of the endogenous proteolysis activation in a number of serious diseases has existed for a long time, the large group of antifermental drugs has been created and widely used. The hemosorbent, capable of selectively removing from the blood the most significant class of serine proteases in purulent septic pathology, was developed and tested in the clinic. The nature of the hemosorbents` therapeutic effect and the status of the proteins metabolism certain parts in connection with the application for haemosorption with biospecific antiproteinase hemosorbents has been studied in patients with diffuse purulent peritonitis of appendicular origin.Понимание ведущей роли активации системы эндогенного протеолиза при ряде тяжелых заболеваний существовало достаточно давно, была создана и широко применялась большая группа антиферментных препаратов. Учитывая это обстоятельство, был разработан и испытан в клинике гемосорбент, способный избирательно извлекать из крови наиболее значимый при гнойно-септической патологии класс сериновых протеиназ. Характер лечебного действия и состояние некото­рых звеньев белкового метаболизма в связи с применением гемосорбции на биоспецифическом антипротеиназном гемосорбенте были изучены в группе пациентов с разлитым гнойным перитонитом аппендикулярного генеза

BIOSPECIFIC HEMOSORBENTS. THE SUCCESSES AND PROBLEMS

Understanding the leading role of the endogenous proteolysis activation in a number of serious diseases has existed for a long time, the large group of antifermental drugs has been created and widely used. The hemosorbent, capable of selectively removing from the blood the most significant class of serine proteases in purulent septic pathology, was developed and tested in the clinic. The nature of the hemosorbents` therapeutic effect and the status of the proteins metabolism certain parts in connection with the application for haemosorption with biospecific antiproteinase hemosorbents has been studied in patients with diffuse purulent peritonitis of appendicular origin

POLYMYXIN-SEWN HEMOSORBENT FOR THE TREATMENT OF PATIENTS WITH SEPTIC SHOCK

ABSTRACT. The key component of the sepsis pathogenesis is the gram-negative bacteria endotoxin. It is a lipopolysaccharide of the bacterial wall, which circulation in the bloodstream results in unlimited activation of some biological systems, causing serious complications. Nowadays, there are developed and practiced sorption methods, based on the selective removal of the lipopolysaccharide from the blood during perfusion through the sorption column with covalently immobilized polymyxin on a bioinert matrix, which can bind and inactivate it. The therapeutic effect of hemosorption using the biospecific antilipopolysaccharide hemosorbent has been studied in patients with septic shock, associated with peritonitis and septic complications of destructive pancreatitis

Impact of inferior vena cava obstruction during orthotopic liver transplantation without venovenous bypass grafting on early postoperative renal function (pilot analysis)

Ligation of the inferior vena cava (IVC) during classical orthotopic liver transplantation (OLT) may be followed by pronounced hemodynamic changes and may provoke renal dysfunction. The authors have examined the impact of IVC ligation during OLT without venovenous bypass grafting on early postoperative renal function in 6 patients. The Cockcroft-Gault formula was used to evaluate renal function from the creatinine clearance on postoperative days 1, 3, 7, and 10. The endogenous creatinine clearance was diminished within the first 24 hours after surgery; this was 68.2±18.1 (24.3—146) ml/min and significantly correlated with that before OLT, with the mean blood pressure (BPmean) in the icteric period, and with age. At the same time, icteric BPmean was in the normal range — 77.2±1.59 (71.6—81.6) mm Hg and clinical renal failure developed in a female patient with significant preoperative renal dysfunction. Thus, IVC ligation at OLT with IVC interposition in the study contributed to a lower endogenous creatinine clearance within the first 24 postoperative hours, but results in no clinical renal function aggravation