The state of the immune system in abdominal sepsis.

Aim: To evaluate the prognostic value of cytokine profile, phagocytosis activity indices, endotoxin concentration and activity in blood in gram-negative sepsis.

Materials And Methods: 78 patients with abdominal sepsis were included in a one-center prospective cohort study, of them 45 died. All the patients were evaluated for the concentration of circulating cytokines (TNF-α, IFN-γ, IL-6, IL-8, IL-10), cellular molecules (CD3, CD45RO, CD95 and HLA-DR), bactericidal and phagocytic activity of neutrophils and endotoxin (lipopolysaccharide) level in peripheral blood.

[Effectiveness of hemofiltration in patients with peritonitis and acute respiratory distress syndrome].

The subjects of the study were 149 patients with severe pyo-septic complications of abdominal diseases, resulting in multiple organ failure syndrome (MOFS) with clinical and laboratory manifestations. Acute respiratory distress syndrome (ARDS) as a component of MOFS was diagnosed in 39 (26.2%) patients.

[Continuous low-flow vein-vein hemofiltration in peritonitis: changes in the severity of endotoxicosis as a criterion for the efficiency of the technique].

The efficiency of intermittent and continuous hemofiltration was comparatively evaluated in the complex treatment of 27 patients having multiple organ dysfunction along with pyoseptic complications of abdominal diseases. Based on the study of a broad spectrum of markers of toxicosis and the severity of organ dysfunction, it was concluded that the efficiency of the procedure should be objectively evaluated to optimize the time of its performance.

[Selective detoxication of the portal vein blood in toxic hepatopathy in patients with peritonitis].

Selective detoxication of the blood from the portal vein was carried out in 31 patients with peritonitis complicated by multiple organ dysfunction including toxic hepatopathy. Selective extracorporeal detoxication of the blood from the portal vein possesses notable regional hemodynamic advantages in comparison with other variants of vascular approaches and essentially improves the transhepatic bloodflow. The authors emphasize that bifiltration cascade exchange portoplasmapheresis is a method of choice in severe toxic hepatopathy in patients with peritonitis.