[Extrarenal purification of blood in patients with multiple organ failure: results and prognostic criteria].
Acetate hemodialysis (HD) with an artificial kidney an continuous hemofiltration were used in the treatment of 49 patients with the multiple organ failure syndrome (MOFS) developing as a complication of aortocoronary and mammary-coronary shunting and heart valve replacement. MOFS involved failure of the function of 3.5 +/- 0.2 vital organs on average. Acute circulatory disorders were observed in 100% of patients, acute renal failure in 75.5%, and perioperative myocardial infarction in 34.7%. In 93.9% of patients HD and HF were combined with forced ventilation of the lungs, in 97.9% with catecholamine infusion, in 26.5% with assisted circulation, and in 57.1% with the Swan-Ganz monitoring of the central hemodynamics and of oxygen transporting function of circulation. Multiple-modality intensive care resulted in survival of 21 (42.8%) patients. The survival of patients with MOFS depended on the number of involved organs, method of extracorporeal detoxication, and monitoring of central hemodynamics and oxygen-transporting function of the blood. Acute renal failure, respiratory distress syndrome, and shock deteriorated the prognosis for patients with MOFS.
Nikiforov
Iu V
IuV
Lebedeva
R N
RN
Chudakov
I E
IE
Griaznov
S V
SV
D058186:Acute Kidney Injury / Q000628:therapy; D002395:Catecholamines / Q000008:administration & dosage; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D003422:Critical Care; D006351:Heart Valves / Q000601:surgery; D006439:Hemodynamics; D006440:Hemofiltration; D006801:Humans; D007263:Infusions, Parenteral; D007387:Internal Mammary-Coronary Artery Anastomosis; D008991:Monitoring, Physiologic; D009102:Multiple Organ Failure / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D006435:Renal Dialysis; D012121:Respiration, Artificial
D002395:Catecholamines