[INFLUENCE OF EXTRACORPOREAL DETOXIFICATION METHODS ON TISSUE PERFUSION IN SEPTIC SHOCK].

OBJECTIVE: To improve the results of abdominal sepsis treatment by comprehensive application of extracorporeal detoxification methods controlled by tissue perfusion.

SUBJECT AND METHODS: Fifteen patients with abdominal sepsis were examined, septic shock was diagnosed to all of them. Patients were divided into two groups. The first group (n = 7) consists of patients with acute renal failure, who had undergone adsorption of Lipopolysaccharide. The second group (n = 8) consists of patients with acute renalfailure, who had undergone prolonged hemofiltration regardless of the products of nitrogen metabolism level to terminate systemic inflammatory response. Dynamic monitoring of tissue perfusion was performed using Doppler ultrasound flowmeter methods.

RESULTS: According to high frequency Doppler ultrasound results all the patients with abdominal sepsis have significant peripheral circulatory disorders maintaining in volumetric and linear blood flow velocity reduction. As a result of application extracorporeal detoxification methods indexes of tissue perfusion were improved. Performance of selective endotoxine hemosorbtion and hemofiltration provides substantially stabilizing effect on Doppler microcirculation indexes: average volumetric blood flow velocity (Qam) increased 4.5 times, end-diastolic linear blood flow velocity (Vakd)--increased to 85%, peripheral resistance index (RI) reduced 2.8 times. Doppler tissue perfusion indexes monitoring allows directly monitor extracorporeal detoxification methods effectiveness, supplementing system hemodynamic monitoring data.

CONCLUSION: Timely application extracorporeal detoxification methods in abdominal sepsis can improve tissue perfusion.