[Variants of the treatment of critical states with consideration of the pathogenesis of the systemic inflammatory response syndrome].

A total of 182 critical patients with sepsis (n = 62), prolonged compression syndrome (PCS) (n = 41), toxic allergic dermatitis (TAD) presenting as Lyell's and Stevens-Johnson's syndromes (n = 54), and stages I-II status asthmaticus (SA) (n = 25) were examined. Statistical computer processing of the data by the method of comparing the means and analysis of correlations revealed a cascade of numerous mediators and metabolites which can be regarded as manifestations of the systemic inflammatory response syndrome (SIRS). This syndrome develops as a reaction to infection, toxic products of microorganisms, ischemic reperfusion lesions, and humoral cytotoxic reactions and is responsible for the formation of multiple organ disorders. Inefficiency of 7-10-day traditional intensive care necessitated active repair of the natural defense mechanisms and addition to the therapeutic complexes of hemo- and plasmaxenosplenoperfusion variants developed by the authors. Despite multiple organ disorders, splenoperfusion decreased the period of critical state from 24 to 12 days in sepsis, from 28 to 18 days in TAD, from 14 to 10 days in PCS, and from 17 to 7 days in SA. The mortality in sepsis dropped from 32.4 to 8%, in TAD from 10.7 to 4%, in PCS from 38.8 to 14.7%, and in SA from 15.9 to 5%. No additional drug therapy or equipment was needed.