[The level of dead blood leukocytes in sepsis and the significance of their elimination by extracorporeal hemocorrection techniques].
Sepsis with 18-to-33% mortality also remains the most serious problem of modem medicine today. Forty-five patients treated at the N. V. Sklifosovsky Research Institute of Emergency Care in June 2006 to February 2008 were examined. Twenty-seven primary blood donors were examined to determine the physiological concentration of dead leukocytes. Two groups of patients were formed according to the signs of a systemic inflammatory reaction (SIR). A study group included 29 patients in whom the course of the underlying disease was complicated by the development of sepsis. All the patients from the study group underwent extracorporeal hemocorrection techniques (EHT): plasma filtration (PF) and continuous venovenous hemofiltration (CVVHF). A granulocytopheresis procedure was performed in 4 patients. A control group comprised 16 patients without clinical signs of SIR. The blood taken from patients with sepsis showed the significant increase in the levels of dead leukocytes as compared with both the physiological normal values and the values obtained in patients without signs of systemic inflammation, which significantly correlates with the severity of organ dysfunction. The elevated content of dead leukocytes is an independent risk factor for a poor outcome. Plasma filtration used in sepsis patients facilitates a significant reduction in the blood concentration of dead leukocytes. The first experience with granulocytopheresis in patients with severe sepsis, a leukemoid reaction and high absolute concentrations of dead leukocytes is indicative of its clinical effectiveness, which is manifested itself by the elimination of dead leukocytes.
Aleksandrova
I V
IV
Reĭ
S I
SI
Khvatov
V B
VB
Borovkova
N V
NV
Il'inskiĭ
M E
ME
Abakumov
M M
MM
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D016923:Cell Death; D005260:Female; D006440:Hemofiltration; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D011237:Predictive Value of Tests; D018805:Sepsis / Q000097:blood / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult