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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rmt</journal-id><journal-title-group><journal-title xml:lang="ru">Общая реаниматология</journal-title><trans-title-group xml:lang="en"><trans-title>General Reanimatology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1813-9779</issn><issn pub-type="epub">2411-7110</issn><publisher><publisher-name>FSBI "SRIGR" RAMS</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15360/1813-9779-2024-4-23-29</article-id><article-id custom-type="elpub" pub-id-type="custom">rmt-2506</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПРАКТИКУЮЩЕМУ ВРАЧУ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>FOR PRACTIONER</subject></subj-group></article-categories><title-group><article-title>Эффективность гемосорбции цитокинов с помощью устройства Efferon CT при тяжелом остром панкреатите</article-title><trans-title-group xml:lang="en"><trans-title>Efficacy of Cytokine Hemoadsorption with Efferon CT in Severe Acute Pancreatitis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Киселев</surname><given-names>В. B.</given-names></name><name name-style="western" xml:lang="en"><surname>Kiselev</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владимир Валерьевич Киселев</p><p>129090, г. Москва, Большая Сухаревская пл., д. 3, стр. 1</p></bio><bio xml:lang="en"><p>Vladimir V. Kiselev</p><p>3 Bolshaya Sukharevskaya Square, Bldg. 1, 129090 Moscow</p></bio><email xlink:type="simple">kiselevvv@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жигалова</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhigalova</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129090, г. Москва, Большая Сухаревская пл., д. 3, стр. 1</p></bio><bio xml:lang="en"><p>Mariya S. Zhigalova</p><p>3 Bolshaya Sukharevskaya Square, Bldg. 1, 129090 Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Клычникова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Klychnikova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129090, г. Москва, Большая Сухаревская пл., д. 3, стр. 1</p></bio><bio xml:lang="en"><p>Elena V.</p><p>3 Bolshaya Sukharevskaya Square, Bldg. 1, 129090 Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рей</surname><given-names>С. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Rey</surname><given-names>S. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129090, г. Москва, Большая Сухаревская пл., д. 3, стр. 1</p></bio><bio xml:lang="en"><p>Sergei I. Rey</p><p>3 Bolshaya Sukharevskaya Square, Bldg. 1, 129090 Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ярцев</surname><given-names>П. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Yartsev</surname><given-names>P. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>129090, г. Москва, Большая Сухаревская пл., д. 3, стр. 1</p></bio><bio xml:lang="en"><p>Petr A. Yartsev</p><p>3 Bolshaya Sukharevskaya Square, Bldg. 1, 129090 Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">НИИ скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы<country>Россия</country></aff><aff xml:lang="en">N. V. Sklifosovsky Research Institute of Emergency Medicine, Moscow City Health Department<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>06</day><month>09</month><year>2024</year></pub-date><volume>20</volume><issue>4</issue><fpage>23</fpage><lpage>29</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Киселев В.B., Жигалова М.С., Клычникова Е.В., Рей С.И., Ярцев П.А., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Киселев В.B., Жигалова М.С., Клычникова Е.В., Рей С.И., Ярцев П.А.</copyright-holder><copyright-holder xml:lang="en">Kiselev V.V., Zhigalova M.S., Klychnikova E.V., Rey S.I., Yartsev P.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.reanimatology.com/rmt/article/view/2506">https://www.reanimatology.com/rmt/article/view/2506</self-uri><abstract><sec><title>Цель исследования</title><p>Цель исследования. Определение влияния гемосорбции цитокинов на клинические проявления и лабораторные показатели у пациентов с тяжелым острым панкреатитом (ТОП).</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В одноцентровое обсервационное контролируемое пилотное исследование включили 34 пациента, 25 мужчин (73,4%) и 9 женщин (26,4%), находившихся на лечении в НИИ СП им. Н. В. Склифосовского ДЗМ в период с мая 2022 г. по август 2023 г. с диагнозом ТОП (ClinicalTrials.gov ID NCT05695001). Средний возраст составил 42,7±12,6 лет. Пациентов разделили на две группы. В основной группе (n=9, 8 мужчин и 1 женщина, средний возраст 37,2±9,4 года) пациентам проводили стандартную терапию, дополненную проведением гемосорбции цитокинов и заместительной почечной терапии методом продленной вено-венозной гемофильтрации (ПВВГФ) в первые 72 ч от начала абдоминального болевого синдрома. В группе сравнения (n=25,18 мужчин и 7 женщин, средний возраст 44,7±13,2 года) проводили аналогичную терапию, но без применения гемосорбции цитокинов.</p></sec><sec><title>Результаты</title><p>Результаты. Статистически значимые различия между группами отметили через 24 ч от момента поступления пациентов в ОРИТ. Они выражались в более низких концентрациях лактата (p=0,045) и IL-6 (p&lt;0,001) в основной группе, чем в группе сравнения. Через 72 ч выявленное межгупповое различие концентрации лактата и IL-6 сохранилось (p&lt;0,001 и p&lt;0,05 соответственно). Выявили тенденцию к сокращению сроков пребывания пациентов основной группы в ОРИТ. Медиана времени до перевода из ОРИТ пациентов основной группы составила 6 сут [95% ДИ: 4–25], в то время как в группе сравнения — 37 сут [95% ДИ: 22–3], p=0,078.</p></sec><sec><title>Заключение</title><p>Заключение. Проведение ПВВГФ при лечении пациентов с ТОП является эффективным методом экстракорпоральной детоксикации, однако менее специфично в отношении удаления провоспалительных маркеров, чем адсорбция цитокинов. Учитывая полученные данные, следует полагать, что комбинация двух указанных методов обладает наибольшей эффективностью при лечении пациентов с ТОП.</p></sec></abstract><trans-abstract xml:lang="en"><p>The aim of the study was to evaluate the eﬀect of cytokine hemoadsorption on clinical manifestations and laboratory parameters in patients with severe acute pancreatitis (SAP).</p><sec><title>Materials and methods</title><p>Materials and methods. The single-center, observational, controlled pilot study included 34 patients, 25 men (73.4%) and 9 women (26.4%), treated for severe acute pancreatitis (SAP) at the N. V. Sklifosovsky Emergency Care Research Institute from May 2022 to August 2023 (ClinicalTrials.gov ID NCT05695001). The mean age of the patients was 42.7±12.6 years. Participants were divided into two groups. In the main group (8 men and 1 woman], mean age 37.2±9.4 years), standard care was supplemented by selective cytokine hemoadsorption (SCH) and renal replacement therapy (RRT) using continuous veno-venous hemoﬁltration (CVVH) in the ﬁrst 72 hours after the onset of abdominal pain syndrome (APS). In the control group (N=25, 18 men and 7 women], mean age 44.7±13.2 years), patients were managed similarly except for SCH.</p></sec><sec><title>Results</title><p>Results. After 24 hours in the ICU, the study group had signiﬁcantly lower levels of lactate (P=0.045) and IL-6 (P&lt;0.001) than the control group. Lactate and IL-6 concentrations remained signiﬁcantly diﬀerent between groups at 72 hours (P&lt;0.001 and P&lt;0.05, respectively). ICU stay was signiﬁcantly shorter in the study group, with a median of 6 days [95% CI, 4–25] before transfer to the general ward, whereas patients in the control group spent 37 days [95% CI, 22–73] in the ICU (P&lt;0.001).</p></sec><sec><title>Conclusion</title><p>Conclusion. CVVH is an eﬀective method of extracorporeal detoxiﬁcation in the management of SAP, but it is less speciﬁc than cytokine adsorption in terms of elimination of proinﬂammatory markers. The data obtained provide suﬃcient evidence to consider the combination of these two modalities as the most eﬀective approach for the management of SAP.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>острый панкреатит</kwd><kwd>цитокиновая гемосорбция</kwd><kwd>Efferon CT</kwd><kwd>органная недостаточность</kwd><kwd>провоспалительные цитокины</kwd></kwd-group><kwd-group xml:lang="en"><kwd>acute pancreatitis</kwd><kwd>cytokine hemoadsorption</kwd><kwd>Efferon CT</kwd><kwd>organ failure</kwd><kwd>proinflammatory cytokines</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Исследование выполнено при финансовой поддержке АО Эфферон, Россия.</funding-statement></funding-group><funding-group xml:lang="en"><funding-statement>The study was ﬁnancially supported by JSC Eﬀeron, Russia.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ревишвили А.Ш., Кубышкин В.А., Затевахин И.И., Багненко С.Ф., Полушин Ю.С., Майстренко Н.А., с соавт. 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