Organ dysfunction

One reason for the high mortality in peritonitis is a violation of organ function in the postoperative period. The elimination of organ dysfunction or failure - is the main therapeutic problem of the postoperative period. Criteria for organ failure, together with criteria of systemic reaction to inflammation developed in the last decade, but the discussion and to this day. In our view, in this condition is not only the choice of surgical tactics, but the complex correction of endogenous intoxication.

Analyzed the results of treatment 284 patients with disseminated purulent peritonitis, treatment is carried out semi-closed and semi-open (58 patients) ways. Criteria for brand viagra diagnosis of abdominal sepsis was determined syndrome of systemic inflammatory response (SIRS). Criteria for failure of the function of scale estimated by APACHE II. Studied a subgroup formed as follows: SIRS 0 - absence syndrome systemic reaction to inflammation; SIRS 1 - the presence of SIRS; SIRS 2 - the presence of SIRS and monoorgannoy failure; SIRS 3 - the presence of SIRS and multiple organ failure. 61 patients in the postoperative period was carried out indirect electrochemical detoxication by intravenous 0.06% sodium hypochlorite solution (an average of 2-3 sessions).

Marked correlation between the severity and mortality in the treatment of semi-closed method. SIRS group 0 - Score APACHE II 11,1 - CFR 4.8%; SIRS group 1 - Score APACHE II 11,5 - CFR 6.1%; SIRS group 2 - score APACHE II 14,3 - 23,3% lethality ; group SIRS 3 - score APACHE II 18,3 - 54,8% lethality. Mortality in the subgroup of SIRS 0 in a greater degree due to comorbidity (65%) and thromboembolic complications (20%). In the absence of MODS in the treatment of semi-closed and semi-open ways lethality is almost the same - about 5%, but in the SIRS group, 3 in the treatment of semi-open way of decreased mortality by 19% (at the landmark reorganization of the abdominal cavity - 38,9%). Application in the postoperative period in the complex treatment of indirect electrochemical detoxication detoxification has a pronounced effect, resulting in low levels of intoxication.
Thus, in the treatment of general purulent peritonitis, the use of semi-fashion shows until the phenomena of multiple organ failure. Application of semi-open method is most effective in severe peritonitis. Postoperatively, appropriate application of electrochemical detoxification.

metabolism
placebo
life moves
blood reaches
wrong interpretation