ИННОВАЦИОННЫЕ ТЕХНОЛОГИИ В ИНТЕНСИВНОЙ ТЕРАПИИ СЕПСИСА У ДЕТЕЙ

  • В. К. Сергиенко Гродненский государственный медицинский университет, Гродно, Беларусь https://orcid.org/0000-0001-7646-0183
  • Р. Э. Якубцевич Гродненский государственный медицинский университет, Гродно, Беларусь https://orcid.org/0000-0002-8699-8216
  • В. А. Кажина Гродненский государственный медицинский университет, Гродно, Беларусь
Ключевые слова: дети, сепсис, септический шок, экстракорпоральная гемокоррекция, гемосорбция, плазмафильтрация, почечная заместительная терапия, гемофильтрация, гемодиафильтрация

Аннотация

Сепсис у детей до сих пор сопровождается высокой смертностью, особенно в развивающихся странах, а ежегодные затраты на лечение составляют миллиарды долларов. В настоящее время активно и успешно разрабатываются и внедряются в практику разные методы и комбинации экстракорпорального очищения крови в зависимости от особенностей клинического течения сепсиса, его вида и тяжести. Однако не все методы экстракорпоральной гемокоррекции у детей и взрослых до конца изучены применительно к той или иной критической ситуации. В представленном обзоре литературы приведены современные данные об экстракорпоральных методах гемокоррекции у детей. Особое внимание уделено инновационным технологиям в интенсивной терапии острого почечного повреждения, индуцированного сепсисом, и методам гемосорбции эндотоксина и цитокинов у взрослых и у детей.

Литература

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-10. https://doi.org/10.1001/jama.2016.0287.

Plevin R, Callcut R. Update in sepsis guidelines: what is really new? Trauma Surg Acute Care Open. 2017;2(1):e000088. https://doi.org/10.1136/tsaco-2017-000088.

Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, Angus DC, Reinhart K; International Forum of Acute Care Trialists. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med. 2016;193(3):259-72. https://doi.org/10.1164/rccm.201504-0781OC.

Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223-230. https://doi.org/10.1016/S2213-2600(18)30063-8.

Weiss SL, Fitzgerald JC, Pappachan J, Wheeler D, Jaramillo-Bustamante JC, Salloo A, Singhi SC, Erickson S, Roy JA, Bush JL, Nadkarni VM, Thomas NJ. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med. 201515;191(10):1147-57. https://doi.org/10.1164/rccm.201412-2323OC.

Balamuth F, Weiss SL, Neuman MI, Scott H, Brady PW, Paul R, Farris RW, McClead R, Hayes K, Gaieski D, Hall M, Shah SS, Alpern ER. Pediatric severe sepsis in U.S. children’s hospitals. Pediatr Crit Care Med. 2014;15(9):798-805. https://doi.org/10.1097/PCC.0000000000000225.

Ames SG, Davis BS, Angus DC, Carcillo JA, Kahn JM. Hospital Variation in Risk-Adjusted Pediatric Sepsis Mortality. Pediatr Crit Care Med. 2018;19(5):390-396. https://doi.org/10.1097/PCC.0000000000001502.

Evans IVR, Phillips GS, Alpern ER, Angus DC, Friedrich ME, Kissoon N, Lemeshow S, Levy MM, Parker MM, Terry KM, Watson RS, Weiss SL, Zimmerman J, Seymour CW. Association Between the New York Sepsis Care Mandate and In-Hospital Mortality for Pediatric Sepsis. JAMA. 2018;320(4):358-367. https://doi.org/10.1001/jama.2018.9071.

Yusef D, Shalakhti T, Awad S, Algharaibeh H, Khasawneh W. Clinical characteristics and epidemiology of sepsis in the neonatal intensive care unit in the era of multi-drug resistant organisms: A retrospective review. Pediatr Neonatol. 2018;59(1):35-41. https://doi.org/10.1016/j.pedneo.2017.06.001.

Carlton EF, Barbaro RP, Iwashyna TJ, Prescott HC. Cost of Pediatric Severe Sepsis Hospitalizations. JAMA Pediatr. 2019;173(10):986-987. https://doi.org/10.1001/jamapediatrics.2019.2570.

Watson RS, Carcillo JA, Linde-Zwirble WT, Clermont G, Lidicker J, Angus DC. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2003;167(5):695-701. https://doi.org/10.1164/rccm.200207-682OC.

Randolph AG, McCulloh RJ. Pediatric sepsis: important considerations for diagnosing and managing severe infections in infants, children, and adolescents. Virulence. 2014;5(1):179-89. https://doi.org/10.4161/viru.27045.

Lee CY, Chen PY, Huang FL, Lin CF. Microbiologic spectrum and susceptibility pattern of clinical isolates from the pediatric intensive care unit in a single medical center - 6 years’ experience. J Microbiol Immunol Infect. 2009;42(2):160-5.

Kieser KJ, Kagan JC. Multi-receptor detection of individual bacterial products by the innate immune system. Nat Rev Immunol. 2017;17(6):376-390. https://doi.org/10.1038/nri.2017.25.

Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, Nadel S, Schlapbach LJ, Tasker RC, Argent AC, Brierley J, Carcillo J, Carrol ED, Carroll CL, Cheifetz IM, Choong K, Cies JJ, Cruz AT, De Luca D, Deep A, Faust SN, De Oliveira CF, Hall MW, Ishimine P, Javouhey E, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med. 2020;46(Suppl 1):10-67. https://doi.org/10.1007/s00134-019-05878-6.

Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C, Simpson S, Wiersinga WJ, Alshamsi F, Angus DC, Arabi Y, Azevedo L, Beale R, Beilman G, Belley-Cote E, Burry L, Cecconi M, Centofanti J, Coz Yataco A, De Waele J, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181-1247. https://doi.org/10.1007/s00134-021-06506-y.

Nacionalnoe obshhestvo specialistov v oblasti gemafereza i jekstrakorporalnoj gemokorrekcii; Afanaseva OI, Voinov VA, Goldfarb JuS, Gurevich KJa, Kalinin NN, Komov VV, Pokrovskij SN, Rej SI, Sokolov AA, Soloveva IN, Jarustovskij MB, Urmanova LJe, Jestrina MA, Ulrih Ju. Jekstrakorporalnaja gemokorrekcija: terminologija, jazykovye sootvetstvija. Moskva, Sankt-Peterburg: IMZhSPB; 2019. 31 p. (Russian).

Ankawi G, Neri M, Zhang J, Breglia A, Ricci Z, Ronco C. Extracorporeal techniques for the treatment of critically ill patients with sepsis beyond conventional blood purification therapy: the promises and the pitfalls. Crit Care. 2018;22(1):262. https://doi.org/10.1186/s13054-018-2181-z.

Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Bellinghan GJ, Bernard GR, Chiche JD, Coopersmith C, De Backer DP, French CJ, Fujishima S, Gerlach H, Hidalgo JL, Hollenberg SM, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43(3):304-377. https://doi.org/10.1007/s00134-017-4683-6.

Bagshaw SM, Wald R. Strategies for the optimal timing to start renal replacement therapy in critically ill patients with acute kidney injury. Kidney Int. 2017;91(5):1022-1032. https://doi.org/10.1016/j.kint.2016.09.053.

Ronco C, Garzotto F, Brendolan A, Zanella M, Bellettato M, Vedovato S, Chiarenza F, Ricci Z, Goldstein SL. Continuous renal replacement therapy in neonates and small infants: development and first-in-human use of a miniaturised machine (CARPEDIEM). Lancet. 2014;383(9931):1807-13. https://doi.org/10.1016/S0140-6736(14)60799-6.

Vidal E, Cocchi E, Paglialonga F, Ricci Z, Garzotto F, Peruzzi L, Murer L, Ronco C. Continuous Veno-Venous Hemodialysis Using the Cardio-Renal Pediatric Dialysis Emergency MachineTM: First Clinical Experiences. Blood Purif. 2019;47(1-3):149-155. https://doi.org/10.1159/000494437.

Garzotto F, Vidal E, Ricci Z, Paglialonga F, Giordano M, Laforgia N, Peruzzi L, Bellettato M, Murer L, Ronco C. Continuous kidney replacement therapy in critically ill neonates and infants: a retrospective analysis of clinical results with a dedicated device. Pediatr Nephrol. 2020;35(9):1699-1705. https://doi.org/10.1007/s00467-020-04562-y.

Goldstein SL, Vidal E, Ricci Z, Paglialonga F, Peruzzi L, Giordano M, Laforgia N, Ronco C. Survival of infants treated with CKRT: comparing adapted adult platforms with the Carpediem™. Pediatr Nephrol. 2022;37(3):667-675. https://doi.org/10.1007/s00467-021-05180-y.

Liu ID, Ng KH, Lau PY, Yeo WS, Koh PL, Yap HK. Use of HF20 membrane in critically ill unstable low-bodyweight infants on inotropic support. Pediatr Nephrol. 2013;28(5):819-22. https://doi.org/10.1007/s00467-012-2394-3.

Santiago MJ, López-Herce J. Prismaflex HF20 for continuous renal replacement therapy in critically ill children. Artif Organs. 2011;35(12):1194. https://doi.org/10.1111/j.1525-1594.2011.01367.x.

Menon S, Broderick J, Munshi R, Dill L, DePaoli B, Fathallah-Shaykh S, Claes D, Goldstein SL, Askenazi DJ. Kidney Support in Children using an Ultrafiltration Device: A Multicenter, Retrospective Study. Clin J Am Soc Nephrol. 2019;14(10):1432-1440. https://doi.org/10.2215/CJN.03240319.

Ronco C, Ricci Z. Pediatric continuous renal replacement: 20years later. Intensive Care Med. 2015;41(6):985-93. https://doi.org/10.1007/s00134-015-3807-0.

John JC, Taha S, Bunchman TE. Basics of continuous renal replacement therapy in pediatrics. Kidney Res Clin Pract. 2019;38(4):455-461. https://doi.org/10.23876/j.krcp.19.060.

Yakubtsevich RE. Jekstrakorporalnoe ochishhenie krovi pri sepsise: sovremennoe sostojanie voprosa [Extracorporeal blood purification in sepsis: modern state of the problem]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta [Journal of the Grodno State Medical University]. 2017;15(2):131-136. edn: ZDIPYJ. (Russian).

Long EJ, Taylor A, Delzoppo C, Shann F, Pearson G, Buckley D, Butt W. A randomised controlled trial of plasma filtration in severe paediatric sepsis. Crit Care Resusc. 2013;15(3):198-204.

Bellomo R, Tetta C, Brendolan A, Ronco C. Coupled plasma filtration adsorption. Blood Purif. 2002;20(3):289-92. https://doi.org/10.1159/000047022.

Hu D, Sun S, Zhu B, Mei Z, Wang L, Zhu S, Zhao W. Effects of coupled plasma filtration adsorption on septic patients with multiple organ dysfunction syndrome. Ren Fail. 2012;34(7):834-9. https://doi.org/10.3109/0886022X.2012.684553.

Livigni S, Bertolini G, Rossi C, Ferrari F, Giardino M, Pozzato M, Remuzzi G. Efficacy of coupled plasma filtration adsorption (CPFA) in patients with septic shock: a multicenter randomised controlled clinical trial. BMJ Open. 2014;4(1):e003536. https://doi.org/10.1136/bmjopen-2013-003536.

Giménez-Esparza C, Portillo-Requena C, ColominaCliment F, Allegue-Gallego JM, Galindo-Martínez M, Mollà Jiménez C, Antón-Pascual JL, Mármol-Peis E, Dólera-Moreno C, Rodríguez-Serra M, Martín-Ruíz JL, Fernández-Arroyo PJ, Blasco-Císcar EM, Cánovas-Robles J, González-Hernández E, Sánchez-Morán F, SoleraSuárez M, Torres-Tortajada J, Palazón-Bru A, Gil-Guillen VF. The premature closure of ROMPA clinical trial: mortality reduction in septic shock by plasma adsorption. BMJ Open. 20193;9(12):e030139. https://doi.org/10.1136/bmjopen-2019-030139.

Daga Ruiz D, Fonseca San Miguel F, González de Molina FJ, Úbeda-Iglesias A, Navas Pérez A, Jannone Forés R. Plasmapheresis and other extracorporeal filtration techniques in critical patients. Med Intensiva. 2017;41(3):174-187. https://doi.org/10.1016/j.medin.2016.10.005.

Jarustovskij MB. Sovremennye metody jekstrakorporalnoj terapii v kompleksnom lechenii sepsisa. Intensivnaja terapija [Intensive Care Journal]. 2008;17(1):3-6. edn: RYCEHZ. (Russian).

Cutuli SL, Artigas A, Fumagalli R, Monti G, Ranieri VM, Ronco C, Antonelli M; EUPHAS 2 Collaborative Group. Polymyxin-B hemoperfusion in septic patients: analysis of a multicenter registry. Ann Intensive Care. 2016;6(1):77. https://doi.org/10.1186/s13613-016-0178-9.

Cruz DN, Antonelli M, Fumagalli R, Foltran F, Brienza N, Donati A, Malcangi V, Petrini F, Volta G, Bobbio Pallavicini FM, Rottoli F, Giunta F, Ronco C. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA. 2009;301(23):2445-52. https://doi.org/10.1001/jama.2009.856.

Klein DJ, Foster D, Walker PM, Bagshaw SM, Mekonnen H, Antonelli M. Polymyxin B hemoperfusion in endotoxemic septic shock patients without extreme endotoxemia: a post hoc analysis of the EUPHRATES trial. Intensive Care Med. 2018;44(12):2205-2212. https://doi.org/10.1007/s00134-018-5463-7.

Sergienko VK, Kazhina VA, Yakubtsevich RE, Spas VV, Klochko AI, Yagovdik IN. Retrospektivnyj analiz jeffektivnosti biospecificheskoj gemoperfuzii pri gnojno-septicheskoj patologii u detej [Retrospective analysis of the effectiveness of biospesific hemoperfusion during purulent-septic diseases in children]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta [Journal of the Grodno State Medical University]. 2012;2(38):41-43. edn: PXPFLP. (Russian).

Kalf-Kalif JaJa. O lejkocitarnom indekse intoksikacii i ego prakticheskom znachenii. Vrachebnoe delo. 1941;(1):31-35. (Russian).

Masjutin VA, Shirokov DM, Pivovarova LP, inventors; Sankt-Peterburgskij nauchno-issledovatelskij institut im. I.I. Dzhanelidze, assignee. Sposob prognozirovanija gnojno-septicheskih oslozhnenij v posttravmaticheskom periode. RU patent 2132065 C1. 1999 Jun 20. (Russian).

Ljubina AJa, Spektor IS, Katasonova TV. Programmirovannoe posobie po metodam klinicheskih laboratornyh issledovanij. Moskva: Medicina; 1971. 208 p. (Russian).




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2022-09-06
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Сергиенко ВК, Якубцевич РЭ, Кажина ВА. ИННОВАЦИОННЫЕ ТЕХНОЛОГИИ В ИНТЕНСИВНОЙ ТЕРАПИИ СЕПСИСА У ДЕТЕЙ. Журнал ГрГМУ (Journal GrSMU) [Интернет]. 6 сентябрь 2022 г. [цитируется по 6 октябрь 2024 г.];20(4):365-73. доступно на: http://journal-grsmu.by/index.php/ojs/article/view/2863

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