[Systemic hemodynamics in constant hemofiltration in patients with septic shock].
Hemodiafiltration (HDF) is a method of pathogenetic therapy for the systemic inflammatory response syndrome in patients with sepsis and shock irrespective of renal failure. Systemic hemodynamics was examined in 18 patients with septic shock treated by HDF (2 groups). HDF was associated with stabilization of systemic hemodynamics in 50% patients (cardiac index, total peripheral resistance, index of the left heart work increased and the number of heart beats, central venous pressure, mean pressure in the pulmonary artery, pulmonary capillary wedging pressure decreased, oxygen consumption index increased, etc.), which allowed a reduction of the initial dopamine and norepinephrine doses 3-fold and lower by the end of days 3-4 of HDF treatment. An opposite tendency was observed in group 2 (refractory shock). Despite high (72.2%) mortality which was mainly caused by the progress of multiple organ dysfunction or untimely surgical intervention, it is obvious that HDF created conditions for surviving the critical period of disease in patients with progressive sepsis.
Iakovleva
I I
II
Timokhov
V S
VS
Pestriakov
E V
EV
Moroz
V V
VV
Murav'ev
O B
OB
Sergeev
A Iu
AIu
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002306:Cardiac Volume; D005260:Female; D006339:Heart Rate; D017583:Hemodiafiltration; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010101:Oxygen Consumption; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D014655:Vascular Resistance