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Introduction:
Acute respiratory
distress syndrome (ARDS) – rather frequent and severe complications of acute
viral bacterial pneumonia and other diseases. ARDS is the major causes of
unfavorable outcomes, despite the use of most modern medicaments. Our previous
experimental studies have demonstrated that endotoxemia is the main cause of
pulmonary parenchyma damaged with development of acute respiratory
insufficiency, multiple organ failure and death in ARDS.
Patients & Methods: We analyzed the therapy of 153
RDS patients: 67 patients received the conventional therapy only (antibiotics
and other drugs, and in severe degree of RDS - mechanical lung ventilation). Seventy
patients received an additional detoxification therapy-hemsorption or plasma
exchange (membrane plasmapheresis with “Hemofenix” device end exchange 1.5-2.5
l of plasma). Ten patients with extremely severe RDS were underwent the
extracorporeal membrane oxygenation of the blood (ECMO) with hemosorption.
Results:
In patients with
severe ARDS and only conventional therapy the lethality level attained 73.33%
while additional performing of hemosorption or plasma exchange allowed to
decrease it to 31.03%. Using ECMO during from 15 to 44 h with 3-4 hemosorption
procedures allowed to save 7 of 10 these patients.
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