title: [THE NEW CONCEPT OF COMBINED USE OF EXTRACORPOREAL BLOOD CORRECTION IN COMPLEX INTENSIVE THERAPY OF SEVERE SEPSIS IN PATIENTS AFTER CARDIAC SURGERY].
abstract: OBJECTIVE
  Clinical and laboratory evaluation of the safety and efficacy of combined application of LPS selective adsorption (using cartridges with immobilized polymyxin B on fibers) and plasma filtration and adsorption (CPFA) in patients with severe sepsis after surgery on the heart and blood vessels.
  
  
  METHODS
  The study involved 40 adult patients with severe sepsis after cardiac surgery. Group I included 20 patients who received the combined therapy with LPS-selective adsorption and CPFA in a single circuit. The control group 2 consisted of 20 patients who received the standard complex intensive therapy of sepsis. Inclusion criteria were clinical and laboratory indices of sepsis (FAA endotoxin activity level above 0.6; procalcitonin 2 ng/ml).
  
  
  RESULTS
  Patients in Group I had an increase in mean aerial pressure by 12% (p = 0.001), the oxygenation index of 36% (p = 0.004), leukocytosis reduction (p = 0.01) and a significant decrease in body temperature (p = 0.0001). We also registered declines of FAA endotoxin activity by 35% (p = 0.0003) and Procalcitonin by 55% (p = 0.005). Patients of the control group had no significant change in the level of white blood cells, procalcitonin, and temperature. 28-day survival rate was 65 and 35% in the 1st and 2nd groups, respectively (p = 0.11).
  
  
  CONCLUSIONS
  Combination of LPS adsorption and CPFA in a single extracorporeal circuit in the complex intensive therapy is a safe and effective treatment of severe sepsis.
authors.forename: M B
authors.initials: MB
authors.lastname: Yarustovsky
authors.forename: M V
authors.initials: MV
authors.lastname: Abramyan
authors.forename: N P
authors.initials: NP
authors.lastname: Krotenko
authors.forename: D A
authors.initials: DA
authors.lastname: Popov
authors.forename: M G
authors.initials: MG
authors.lastname: Plyusch
authors.forename: S L
authors.initials: SL
authors.lastname: Gordeev
authors.forename: E A
authors.initials: EA
authors.lastname: Rogalskaya
mesh_terms: D000327:Adsorption; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D013504:Cardiovascular Surgical Procedures; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*; D011112:Polymyxin B / Q000008:administration & dosage / Q000627:therapeutic use; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000628:therapy*; D018805:Sepsis / Q000097:blood / Q000209:etiology / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D011112:Polymyxin B