ENDOGENOUS INTOXICATION IN PATIENTS WITH ACUTE DIFFUSE PERITONITIS AND THE INCIDENCE OF SEPSIS

Abstract

Goal. Optimization of treatment of endotoxemia and endotoxicosis in patients
with acute diffuse peritonitis by early diagnosis of generalization of infection with the
development of sepsis and timely correction. Materials and methods: a study of 141
patients with acute diffuse peritonitis of various etiologies was conducted, the patients were
divided into 3 groups according to the phases of the prevalence of the process: diffuse,
widespread, purulent - fibrous. Results: in patients with group I with acute diffuse peritonitis,
generalization of the process with the development of sepsis, it was found that peptide
intoxication in patients receiving only infusion-transfusion therapy with forced diuresis
turned out to be quite resistant. Hemosorption, in addition to reducing the period of
endogenous intoxication, reduced the total amount of liquid media for PL and IL. So, the
amount of fluid for PL and IL, in the first 2-3 days in patients of groups II and III, was
almost the same, but further, the volume of lavage fluid for group III was lower. Conclusion.
In patients with ADP, despite the therapy in the postoperative period, generalization of the
process with the development of sepsis occurs in 31.2% of cases, verified clinically by the
studied procalcitonin test. With diffuse fibrinous-purulent peritonitis, the frequency of
generalization of infection reaches 50%, with serous-fibrinous diffuse peritonitis - 32.2%.
with serous peritonitis - 3.9%.