Extracorporeal detoxification in patients with sepsis at complicated diabetic foot syndrome
DOI:
https://doi.org/10.11603/2414-4533.2016.1.5885Abstract
Under our supervision there were 713 patients with sepsis who were treated in septic city center with beds diabetic foot for the period 1991–2015rr. In 90.9 % of cases (648 patients) were the cause of sepsis cellulitis soft tissues of different localizations (1 group). In 65 patients (9.1 %) – wet gangrene of the lower limbs and purulent necrotic processes diabetic foot (group 2). During a comprehensive study of patients with sepsis found that last appeared in 81.2 % of cases (579 patients) against opportunistic diseases, which are 15.1 % (108 patients) had signs of decompensation. In this case the adjacent pathology significantly more often (p <0.05) was reported in patients with severe sepsis and its complicated forms.
Intoxication syndrome of a severity was found in all patients with sepsis. Because of detoxification measures were required component of complex intensive care. Despite some effectiveness sessions discretic plasmafaresis (judging by the positive dynamics of objective markers of endotoxemia and other indicators of homeostasis) treatment outcomes of patients with sepsis remain poor. We analyzed survival in a representative group of patients (n=216), which are already complex treatment discretic plasmafaresis was not carried out. From the standpoint of evidence-based medicine 'reference point' was the 28th postoperative day. At 25–30-th day of stay in the hospital died 12 patients with PF used 2–3 times, 11 more patients with PF treatments 3–5 times longer than died in 30 days. Mortality in septic shock – 68.9 % (40 of 58 dead patients) patients of group 1 and 76.2 % (10 of 13 patients) in group 2. The syndrome of multiple organ failure respectively 77.3 % (34 patients) and 87 5 % (6 patients).
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