rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2014-6-39-45rmt-1431Research ArticleЭКСТРАКОРПОРАЛЬНАЯ ДЕТОКСИКАЦИЯ ПРИ СЕПСИСЕEXTRACORPOREAL DETOXIFICATION IN SEPSISВНУТРИЧЕРЕПНОЕ ДАВЛЕНИЕ В УСЛОВИЯХ ВЫСОКООБЪЕМНОЙ ГЕМОФИЛЬТРАЦИИ ПРИ ТЯЖЕЛОМ СЕПСИСЕIntracranial Pressure during HighVolume Hemofiltration in Severe SepsisБердниковА. П.BerdnikovA. P.ГончаренкоС. И.GoncharenkoS. I.МусаеваТ. С.MusaevaT. S.musayeva_tanya@mail.ruЗаболотскихИ. Б.ZabolotskikhI. B.Кубанский государственный медицинский университет Минздрава России, кафедра анестезиологии, реаниматологии и трансфузиологии ФПК, Краснодар, Россия 350000, Россия, г. Краснодар, ул. Седина 4 Краснодарская клиническая больница №2, Краснодар, Россия 350012, Россия, г. Краснодар, ул. Красных Партизан, 6/2РоссияDepartment of Anesthesiology, Reanimatology, and Transfusiology, Faculty for Advanced Training and Professional Retraining of Specialists, Kuban State Medical University, Ministry of Health of Russia, Krasnodar, Russia 4, Sedin St., Krasnodar 350063, Russia Krasnodar Clinical Hospital Two, Krasnodar, Russia 6/2, Krasnye Partizany St., Krasnodar 350063, RussiaRussian FederationКраснодарская клиническая больница №2, Краснодар, Россия 350012, Россия, г. Краснодар, ул. Красных Партизан, 6/2РоссияKrasnodar Clinical Hospital Two, Krasnodar, Russia 6/2, Krasnye Partizany St., Krasnodar 350063, RussiaRussian Federation2014211220141063945Copyright © Бердников А.П., Гончаренко С.И., Мусаева Т.С., Заболотских И.Б., 20142014Бердников А.П., Гончаренко С.И., Мусаева Т.С., Заболотских И.Б.Berdnikov A.P., Goncharenko S.I., Musaeva T.S., Zabolotskikh I.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1431Цель исследования

Цель исследования. Определить прогностическое значение динамики ВЧД в условиях ВОГФ у больных с тяжелым сепсисом и нормальным предперфузионным уровнем внутричерепного давления.

Материал и методы

Материал и методы. Проведено ретроспективное исследование 50 больных (всего 134 процедуры) с тяжелым сепсисом и нормальным уровнем внутричерепного давления (ВЧД) по данным измерения давления в центральной вене сетчатки, которым проводили высокообъемную гемофильтрацию (ВОГФ) по внепочечным показаниям. На основании динамики ВЧД до и после ВОГФ выделено 2 группы: 1я (n=81) — с отсутствием динамики ВЧД; 2я (n=53) — с повышением ВЧД.

Заключение

Заключение. ВОГФ не эффективна в случае увеличения предперфузионно нормального ВЧД у пациентов с тяжелым сепсисом, имеющих сочетание артериовенозной разницы напряжения углекислого газа более 8 мм рт. ст. и уровня по шкале ком Глазго менее 10 баллов.

Objective

Objective: to define the prognostic value of intracranial pressure (ICP) changes in highvolume hemofiltration (HVHF) in patients with severe sepsis and normal preperfusion ICP.

Subjects and methods

Subjects and methods. A retrospective study was conducted in 50 patients (a total of 134 sessions) with severe sepsis and normal baseline ICP who received ther apy using HVHF for extrarenal indications. Based on ICP changes before and after HVHF, the investigators identified 2 groups: 1) no ICP changes (n=81); 2) elevated ICP (n=53).

Conclusion

Conclusion. HVHF is ineffective when the normal preperfusion ICP is increased in patients with severe sepsis who have a concurrence of an arteriovenous carbon dioxide difference of more than 8 mm Hg and a Glasgow coma score of less than 10.

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The authors declare that there are no conflicts of interest present.