Modern approaches to the treatment of postpartum purulent-septic diseases

Иванников, Н. Ю.; Митичкин, А. Е.; Dimitrova, Valentina; Слюсарева, О. А.; Хлынова, С А; Доброхотова, Ю Э

doi:10.21518/2079-701x-2019-7-58-69

Cited by 10 publications

(1 citation statement)

References 3 publications

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“…Одно из наиболее авторитетных международных профессиональных сообществ -Surviving Sepsis Campaign -ограничивается рекомендацией применения продленного или интермиттирующего гемодиализа у пациентов с сепсисом и острой почечной недостаточностью (уровень доказательности 2 В) либо продолженных методик с целью оптимизации волемических нагрузок у гемодинамически нестабильных пациентов с сепсисом (уровень доказательности 2D) [9].…”

Section: Introductionunclassified

Application of citrate dialysis in the treatment of puerperal sepsis

Пенжоян

Andreeva

Пономарев

et al. 2020

Kuban. nauсh. med. vestnik

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Aim. To describe the results of applying citrate dialysis in the complex therapy of a patient with postpartum sepsis.Materials and methods. This paper presents an analysis of a case of the successful treatment of patient P. with the diagnosis “Childbirth 3 urgent. Pfannenstiel laparotomy. Caesarean section in the lower uterine segment. Hypotonic bleeding. Relaparotomy: ligation of the internal iliac arteries, hemostasis. Relaparotomy: additional hemostasis, pelvic tamponade, abdominal cavity tamponade. Hemorrhagic shock of fourth category. Extirpation of the uterus with tubes. Sepsis. Septic shock. DIC syndrome”. Citrate dialysis was included as part of intensive care therapy.Results. Citrate dialysis allowed the patient with multiple organ failure, against the background of complex intensive care therapy, to restore kidney function after 28 sessions of renal replacement therapy. Diuresis was completely restored on day 42. Biochemical parameters, such as urea and creatinine, were normalized on day 45. The duration of treatment in the anesthesiology and resuscitation departments was 47 days, out of which lung mechanical ventilation lasted for 17 days. The total duration of treatment in the hospital was 54 bed days. The patient was discharged in satisfactory condition.Conclusion. The methods of extracorporeal detoxifi cation can signifi cantly improve treatment outcomes in this category of patients and reduce maternal mortality rates.

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Section: Introductionunclassified

Application of citrate dialysis in the treatment of puerperal sepsis

Пенжоян

Andreeva

Пономарев

et al. 2020

Kuban. nauсh. med. vestnik

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Diagnosis of septic complications of postpartum endometritis and treatment of laboring women

Lazareva,

Barinov,

Shifman

et al. 2024

Ross. vestn. akush.-ginekol.

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Complicated infectious endocarditis in a patient with human immunodeficiency virus: A case report

Potemkina¹,

Ylanov²,

Петрова³

2023

Digital Diagnostics

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INTRODUCTION: Infectious endocarditis (IE) in injecting drug patients with human immunodeficiency virus (HIV) is manifested predominantly by damage to the tricuspid valve (TV). The pathogen of the disease is Staphylococcus aureus. The IE peculiarities of the TV in this category of patients are multiple septic emboli in the small circulation, which may result from flotation vegetations, and predominance of pulmonary symptomatology over cardiac phenomena. CASE PRESENTATION: A 30-year-old female HIV-infected injecting drug user was dynamically monitored for the laboratory-confirmed IE development by transthoracic echocardiography during a year. The patient was twice admitted to the intensive care unit in a serious condition with purulent-septic complications in the lungs in the form of bilateral polysegmental destructive (septic) pneumonia confirmed by X-ray and multispiral computed tomography. After intensive therapy, the patient refused further ARV treatment and consultations with a cardiac surgeon. A clinical follow-up demonstrated IE of the TV and right-sided lower lobe pneumonia in an HIV-infected drug-dependent patient after a cesarean section. Immunodeficiency without appropriate ARV therapy had a negative impact on the course of the disease. According to transthoracic echocardiography, an increase in TV vegetations from 7 mm to 16 mm and regurgitation were observed, whereas left ventricular ejection fraction decreased from 60% to 47% during the follow-up. Complications of cesarean section, immunodeficiency, and absence of ARV therapy could be the trigger factors of the IE development. Injection drug use with possible violations of asepsis and circulation of microorganisms of the causative agents in the blood contributed to the rapid development of the disease and was a determining factor of the infectious process in the TV. CONCLUSIONS: Echocardiography remains the primary radiological diagnostic method for examining HIV-infected drug-dependent patients with fever and/or after medical manipulations. However, this group of patients more frequently clinically manifests the disease with bright pulmonary pathology. Therefore, radiological methods should necessarily be a priority during the diagnostic search. The sources of septic embolism in the small circulation in IE may be loose and floating TV vegetations.

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Modern approaches to the treatment of postpartum purulent-septic diseases

Cited by 10 publications

References 3 publications

Application of citrate dialysis in the treatment of puerperal sepsis

Application of citrate dialysis in the treatment of puerperal sepsis

Diagnosis of septic complications of postpartum endometritis and treatment of laboring women

Complicated infectious endocarditis in a patient with human immunodeficiency virus: A case report

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