Zakotyanskyy O. Optimization criteria of severity and intensive care in patients with hepatic dysfunction

The dissertation is devoted to the study of the functional state of the liver, improving liver dysfunction determine the severity and differentiated selection methods of detoxification in patients with severe sepsis, multiple organ dysfunction syndrome complicated with symptoms of acute liver dysfunction. Based on advanced criteria of severity of acute hepatic dysfunction is differentiated into three stages of severity: compensated, subcompensated and decompensated. In patients with severe sepsis complicated by organ dysfunction syndrome, at an early stage of acute liver dysfunction occurs breach synthetic, detoxification of the liver and increases the activity of cytolysis. In patients with severe sepsis, multiple organ dysfunction syndrome complicated with symptoms of acute liver dysfunction, including in complex intensive care enterosorbtion , selective decontamination of the gut , drugs to reduce hyperammonemia and infusion therapy, nutritional support , plasmapheresis and albumin dialysis given stage acute liver dysfunction contribute to more rapid improvement of the functional state of the liver, a positive effect on homeostasis , which reduced the 28 - day mortality in compensated under 3,7%, subcompensated - 4%, decompensated - 1,9%.