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Post a Comment Effective treatment of septic shock using oXiris-therapy in a patient with diffuse fecal peritonitis and severe comorbid background
- Authors: Kotelnikova L.P.1,2, Vereshchagin A.V.2, Sadilov M.V.2
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Affiliations:
- E.A. Vagner Perm State Medical University
- Perm Rgional Clinical Hospital
- Issue: Vol 40, No 5 (2023)
- Pages: 133-141
- Section: Clinical case
- URL: https://journal-vniispk.ru/PMJ/article/view/254816
- DOI: https://doi.org/10.17816/pmj405133-141
- ID: 254816
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Abstract
To assess the efficiency of using the methods of extracorporeal detoxification in the complex treatment of sepsis and septic shock so as to eliminate endotoxin, cytokines as well as to replace the function of organs. The article presents a successful experience of using two sessions of hemofiltration with an oXiris set for extrarenal indications in a patient with diffuse fecal peritonitis and severe comorbid background after surgery. The complex of therapeutic measures, dynamics of clinical and laboratory data before and after both sessions of oXiris therapy is presented. Positive effect of hemofiltration on the patient's condition using the oXiris set was noted 48–72 hours after the start of the procedure and 72 hours after its completion. The use of two sessions of oXiris therapy in the treatment of septic shock in a patient with diffuse fecal peritonitis and severe comorbid background allowed stabilizing hemodynamics 48–72 hours after the start of treatment; a significant improvement of a patient’s condition occurred 72 hours after the end of the second procedure.
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##article.viewOnOriginalSite##About the authors
L. P. Kotelnikova
E.A. Vagner Perm State Medical University; Perm Rgional Clinical Hospital
Email: veralex.80@mail.ru
ORCID iD: 0000-0002-8602-1405
MD, PhD, Professor, Head of the Department of Surgery with Course of Cardiovascular Surgery and Invasive Cardiology, surgeon
Russian Federation, Perm; PermA. V. Vereshchagin
Perm Rgional Clinical Hospital
Author for correspondence.
Email: veralex.80@mail.ru
ORCID iD: 0000-0002-1163-2316
Resuscitator
Russian Federation, PermM. V. Sadilov
Perm Rgional Clinical Hospital
Email: veralex.80@mail.ru
ORCID iD: 0000-0003-1507-5454
Surgeon
Russian Federation, PermReferences
- Chernov V.N., Mareyev D.V. Treatment of abdominal sepsis. Khirurgia (Mosk) 2010; 8: 44–47 (in Russian).
- Khatsko V.V., Potapov V.V., Zenin O.K. Etiology, pathogenesis and diagnosis of sepsis (a review of literature). University proceeding. Volga region 2017; 43 (3): 139–150. doi: 10.21685/2072-3032-2017-3-15 (in Russian).
- Aliev S.A., Aliev E.S. Abdominal sepsis: the state of the problem, integral system for assessing the severity of sepsis and criteria for predicting the result. Vestnik khirurgii 2018; 177 (5): 108–112. doi: 10.24884/0042-4625-2018-177-5-108-112 (in Russian).
- Savel’ev V.S., Gel’fand B.R., Filimonov M.I., Podachin P.V., Sergeeva N.A. Criteria for the selection of effective surgical treatment of widespread peritonitis. Annaly khirurgii 2013; 2: 48–54 (in Russian).
- Kim T.G., Magomedov M.A., Protsenko D.N., Zakharov M.V., Marukhov A.V., Chubchenko N.V. The current state of renal replacement therapy in the treatment of sepsis. Messenger of Anesthesiology and Resuscitation 2021; 4 (18): 80–89. doi: 10.21292/2078-5658-2021-18-4-80-89 (in Russian).
- Polushin Y.S., Dreval R.O., Zabotina A.N. Clinical and economic assessment of the therapy of acute kidney injury in sepsis with continuous combined methods of renal replacement therapy. Messenger of Anesthesiology and Resuscitation 2021; 18 (5): 7–20. doi: 10.21292/2078-5658-2021-18-5-7-20 (in Russian).
- Schwindenhammer V., Girardot T., Chaulier K. et al. oXiris use in septic chock: experience of two French centers. Blood Purification 2019; 21: 1–7. doi: 10.1159/000499510.
- De Rosa S., Villa G., Ronco C. The golden hour of polymyxin B hemoperfution in endotoxic shock: the basis for sequential extracorporal therapy in sepsis. Artif Organs 2020; 44 (2): 184–186. doi: 10.1111/aor.13550.
- Turani F., Barchetta R., Falco M. et al. Continuous renal replacement therapy with the adsorbing filter oXiris in septic patients: a case series. Blood Purification 2019; 47 (3): 1–5. doi: 10.1159/000499589.
- Monard C., Rimmele T., Ronco C. Extra-corporeal blood purification therapies for sepsis. Blood Purification 2019; 47 (3): 2–15. doi: 10.1159/000499520.
- Turani F., Belli A., Martini S., Cotticelli V.C., Mounajergi F., Barchetta R. Oxiris membrane decreases endotoxin during RRT in septic patients with basal EAA 0,6. Crit Care 2016; 20 (2): 196.
- Tengattini M., Prato F., Colageao U., Pissaia C. Hemodynamic monitoring during continuous renal replacement therapy (CRRT) with oXiris filter in septic shock patients. Intensibe Care Medicine Replacement 2018; 6 (12): 301.
- Schwindenhammer V., Girardot T., Chaulier K., Gregoire A., Monard C., Huriaux L., Illinger J., Leray V., Uberti T., Crozon-Clauzel J., Rimmele T. oXiris use in septic shock: experience on two French centres. Blood Purification 2019; 47 (3): 29–35. doi: 10.1159/000499510.
- Wei T., Chen Z., Li P., Tang X., Marshall M., Zhang L., Fu P. Early use of endotoxin absorption by oXiris in abdominal septic shock. Medicine (Baltimore) 2020; 99 (28): e19632. doi: 10.1097/00000000000119632
- Karkar A., Ronco C. Prescription of CRRT: a pathway to optimize therapy. Annals of Intensive Care 2020; 10: 32–42. doi: 10.1186/s13613-020-0648-y
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