Yachnyk I. Early diagnosis of organ failure in children with septic complications.

The dissertation is devoted to the tasks of early diagnosis of organ failure on the background of septic conditions in children. Based on the analysis of the survey and 264 of intensive therapy of children with systemic inflammatorty response syndrome and sepsis, it was found theoretical generalization and practical solution to the improvement of intensive therapy and its effectiveness these children. Expanded the traditional practice of study patients with sepsis seth for the introduction of quantitative determination of C-reactive protein (C-RP), procalcitonin, proinflammatory mediators, indices of cellular immunity, protein S-100 and the use of scientifically based reference positions of decision making, that allows us to detect a severe course of sepsis and take appropriate therapeutic decision. On the basis of the obtained data has developed criteria for the prediction and diagnostic organic disorders using the definition of the extended package of laboratory examination of children with sepsis and SIRS for the inclusion of C-RP, procalcitonin, IL-2, IL-6, IL-8, TNF , indicators of cellular immunity, protein S-100. This increases the diagnostic capability of definition of sepsis and severe sepsis, which is characterized by the dysfunction of organs and systems. As information content, speed and availability you can apply is a quantitative indicator of C-RP. For effectiveness of prescribed antibiotic therapy justified the use of procalcitonin-based Protocol. For the course of sepsis and predict mortality is useful to define the level of IL-2 and IL-8. In order to isolate patients with immunoparalysis effective indicators of cellular immunity: the number of B-lymphocytes, T-helper cells, the ratio CD4/CD8 and traditionally the number of leukocytes. Detection of protein S-100 in patients at risk of encephalopathy. Thus, only through the use of procalcitonin-based antibiotic therapy on the background of scientifically based intensive therapy of sepsis can reduce mortality of 3,8 %.