ИЗМЕНЕНИЕ КОНЦЕНТРАЦИИ В ПЛАЗМЕ МЕРОПЕНЕМА НА ФОНЕ ПРОВЕДЕНИЯ ЭКСТРАКОРПОРАЛЬНОЙ ГЕМОПЕРФУЗИИ ЧЕРЕЗ СЕЛЕКТИВНЫЕ ГЕМОСОРБЕНТЫ У ПАЦИЕНТОВ С СЕПСИСОМ ПРИ ПРОВЕДЕНИИ КОМПЛЕКСНОЙ ИНТЕНСИВНОЙ ТЕРАПИИ

Abstract

Background. Sepsis and septic shock are the main causes of death in intensive care units. Hemoperfusion in combination with standard therapy of sepsis reduces mortality by an average of 5-7%, however, there is evidence that hemosorbents can reduce plasma levels of antibacterial drugs. Purpose of the study. Our aim is to investigate the effect of hemoperfusion on the meropenem plasma levels using the sorbents “Hemoproteazosorb” and “LPS-hemo”. Material and methods. 35 patients with sepsis were examined: a control group without the use of hemoperfusion and two experimental groups, in which hemoperfusion with various sorbents was used. Plasma concentration of meropenem was determined by ELISA. Results. In the control group, a decrease in concentration of meropenem was observed in 27% of cases (decrease value 3.81 µg/ml; p<0.25). In the group of “Hemoproteazosorb” - in 54% of cases after hemosorption (1.33 µg/ml; p<0.02); in “LPS-hemo” group - in 50% of cases (3.08 µg/ml; p<0.06). Conclusions. Hemoadsorption can alter the plasma concentration of meropenem, it is necessary to develop methods of correction such as modifying dosing regimens of an antibacterial drug.