[Hybrid technologies of renal replacement therapy in the treatment of multiple organ failure in cardiosurgical patients].

Composite reparative cardiosurgical operations frequently lead to ischemia and hypoxia of vitally important organs and systems, which may be later a cause of the multiple organ dysfunction syndrome (MODS). Up to now, after operations on the heart and vessels, the incidence of this menacing complication remains rather high. In the postoperative period, isolated acute renal failure (ARF) occurs extremely rarely; its incidence is not greater than 5-8% whereas ARF is much more frequently (as high as 90%) a component of MODS and an indicator of a patient's status. Among patients undergoing cardiac resuscitation, ARF is encountered in 20-27% of cases, 71.7% of them need replacement renal therapy (RRT). The latter should be regarded as an intermediate treatment that allows the patient to survive up to the time that native kidney function restores. Choice of an adequate and effective treatment option for acute renal dysfunction remains to be urgent. On-going discussions between the advocates of continuous RRT (CRRT) and the adherents of intermittent RRT (IRRT) are a prominent case in point. These two modalities have a variety of good and bad points. In this connection, there is an idea of developing hybrid procedures that can combine the best properties of both IRRT and CRRT in order to use them in the treatment of critically ill patients with multiply organ dysfunction and, judging from the first not numerous publications, their application has reduced the incidence of complications due to routine extracorporeal blood purifying procedures.