INTENSIVE THERAPY OF SEPSIS SUPPLEMENTED WITH HEMODIAFILTRATION AND SELECTIVE HEMOSORPTION

Objective. This study assessed the outcomes of intensive sepsis therapy using extracorporeal blood purification techniques using hemodiafiltration and selective hemosorption.

Materials and Methods. Two comparable groups were recruited. In the study group, standard sepsis therapy according to the hospital-approved protocol was supplemented with extracorporeal detoxification using selective hemosorption with hemodiafiltration (SHS+HDF Group). The control group, recruited using a stratified selection method (stratified by age, gender, presence of comorbidities, and severity of condition) from retrospective clinical cases, received a standard treatment protocol with hemodiafiltration (HDF Group). Hemodynamic parameters, inflammatory markers, patient mortality on days 7, 14, and 28, and the severity of the patient's condition using the SOFA, MODS, and LODS scales were assessed.

Results. Extracorporeal detoxification using the method of selective hemosorption with hemodiafiltration has been found to demonstrate the best clinical and laboratory parameters in dynamics and statistically significantly improves the prognosis of survival in sepsis. In particular, the analysis of the hospital survival rate of patients with sepsis demonstrates the significant advantages of the "GHS+GDF" strategy (survival by day 28 was 84% versus 76% with pronounced curve divergence after day 14 of follow-up. At the same time, the level of statistical significance when comparing the curves using the log-rank method was 0,028).

Conclusions. Larger studies using randomized methods are needed for a more detailed analysis of this treatment strategy. Furthermore, a clearer definition of the indications for selective hemosorption is needed.

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