Mosentsev M. The comparative estimation of hepatosplanchnic ischemia and its concequences management methods in septic patients with multiple organ failure

This open, randomized clinical study enrolled 97 adult septic patients with illness severity over the 20 points by the APACHE II score. The effects of empirical tissue oxygenation, the additional protection of barrier function with natural pektine sorbents (NPS), and intraluminal administration of perftoran were evaluated. It has been found, that the splanchnic ischemia is a result of inadequate tissue oxygenation, and the role of intrapulmonary and peripheral oxygen shunt on the splanchnic oxygenation was demonstrated. After the supranormal levels of pattern DO2 - VO2 were achieved, the splanchnic oxygenation was improved, but the reflow paradox and the gut translocation syndrome appeared, and the levels of cytikines were increased. After prevention of gut barrier function with NPS the further disturbances, depending on translocation syndrome, were decreased, and the septic syndrome anf MOF were reduced. Enteral administration of perftoran improved the splanchnic oxygenation, hepatic and nutrition fun ctions, prevented the gastrointestinal bleeding, improved the outcome in septic patients with MOF.