Valerijus Karmanovas, Vilmantė Burokienė
Patient: 5 years old girl arrived to Vilnius university children hospital with diagnosis:chest phlegmona, billateral pneumonia and pneumothorax, sepsis, acute kidney insufficienty, multiple organ dysfunction syndrome ( sepsis due to staphyloccocus aureus).She was treated with antibiotics, infusion therapy, enteral- parenteral nutrition, mandatory ventilation, billateral pleural drenage. After wards it was desided to use renal replacement therapy- continuos venous-venous hemofiltration (because of renal insufficienty and intoxication) and then- 10 hours of coupled plazmafiltration- adsorbtion (Lynda machine).After 72 hospital days (12 ICUdays) she was discharged. Conclusion:nethertherless there is no randomised double blinded solutions for use of renal replacement therapy and blood purification in sepsis treatment, we think ( it,s 25 years experience of variuos extracorporeal detoxication therapies, starting from hemocarboperfusion, plazmafiltration etc.) that clinicaly-laboratory evidence based patients (specially with MODS), should be treated using coupled renal replacement and blood purification methods.
Keyword(s): renal replacement therapy; coupled plasmafiltrationadsorbtion; sepsis; multiple organ dysfunction syndrome
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