Role of hemosorption in the therapy of infectious toxic shock and the multiple-organ failure syndrome in a fulminating form of meningococcemia
Pokrovskiĭ, V.I.; Radzivil, G.G.; Beloborodov, V.B.; Broniakin, I.V.; Roslyĭ, I.M.
Terapevticheskii Arkhiv 58(9): 117-122
1986
ISSN/ISBN: 0040-3660 PMID: 3787481 Document Number: 272377
Hemoperfusion was applied to the treatment of 20 patients with fulminant meningococcemia complicated by the infectious-toxic shock, stage III, and the polyorgan insufficiency syndrome. Ten patients recovered while the remaining 10 died mainly because of irreversible lesions of the vitally important organs: kidneys, adrenals, heart and brain. In the deceased patients, the prehospital stage had lasted two times longer than in the convalescents. All the patients had received antishock therapy: correction of acidosis, artificial ventilation of the lungs, dopamine, pharmacological doses of steroids and protease inhibitors as well as moderate infusion therapy. Hemoperfusion was instituted immediately after elimination of arterial hypotension. The use of hemoperfusion promoted the abatement of systemic toxicosis and neurotoxicosis, the recovery and stabilization of the hemodynamics, improvement of rheological properties of the blood, the recovery of effective tissue perfusion, the lowering of specific antigenemia and blood toxicity, and elimination of the pathological protein complexes from the circulating blood.