[Early application of plasmapheresis for complex treatment of purulent mediastinitis].
Acute purulent mediastinitis (APM) is one of the most difficult forms of surgical infection with severe clinical course and lethality from 17 to 80%. Overall 80 patients with APM were treated; plasmapheresis in postoperative period was used at 66 of them. The main criteria of negative prognosis at the patients with APM were elderly age, high score on APACHE-2, SAPS-2 and SOFA scales, higher level of creatinine and urea serum concentration, hyperglycemia, leucopenia. Early application of plasmapheresis was associated with lower lethality (12.5% at the group with early beginning of plasmapheresis, 35.3% at the group with late beginning, 36.2% at the control group). Plasmapheresis promotes normalization of hemostasis, microcirculation and immune parameters, reduction of intoxication and systemic inflammation syndrome.
Abakumov
M M
MM
Aleksandrova
I V
IV
Reĭ
S I
SI
Dorfman
A G
AG
Nikitina
O V
OV
Davydov
B V
BV
Matveev
S B
SB
Vasina
N V
NV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*; D011300:Preoperative Care; D015996:Survival Rate