Results of the impact of antiproteinase hemosorbent on the dynamics of clinical and laboratory indicators in children with generalized peritonitis

Abstract

Introduction. Despite the undoubted success of modern medicine, peritonitis in children remains not only a surgical, but also a general pathological problem, the relevance of which does not decrease. The use of efferent therapy methods, in particular hemosorption, imitating the natural mechanisms of detoxification of the body, are promising in the complex therapy of children with peritonitis. Aim. The aim of the study was to establish the effectiveness of the antiproteinase hemosorbent „Hemo-proteazsorb” in the complex intensive care of children with generalized peritonitis. Material and methods. A prospective randomized study of 60 children with generalized peritonitis was conducted. In the main group, there were 30 patients who underwent hemosorption in complex intensive care, and the comparison group also included 30 patients who underwent traditional treatment. The examined groups were comparable in terms of the nature of the pathology and the severity of the condition. Results. During hemoperfusion, a significant increase in blood saturation was established from 95.1 (93.2; 97.1)% to 97.3 (95.5; 98.7)%, with an improvement in oxygen transport (ctO2, mmol/l) from 6.9 (6.4; 7.9) to 8.8 (1.5; 9.7) and a decrease in lactate level (mmol/l) from 1.7 (1.5;2.1) to 1.1 (0.9;1.3), which indicates normalization of blood oxygenation and improvement of microcirculation. After 24 hours, there was a significant decrease in the amount of points on the pSOFA scale, from 4.5 (3.0; 6.0) to 0.5 (0; 2.0), p < 0.001, normalization of body temperature, restoration of intestinal function was noted in 15 (50.0% CI: 32.1-67.9) children, which indicates a decrease in multiple organ dysfunction and improvement of the condition. When compared in the second group, the studied indicators changed much more slowly. Conclusions. The data obtained as a result of the study on the positive dynamics of clinical and laboratory parameters prove the high effectiveness of the use of the Belarusian hemosorbent ?Hemo-proteazsorb? in the complex of intensive care of generalized peritonitis.