Abstract
Refractory shock is the shock that does not respond to vasopressor therapy. Refractory shock with a short-term mortality rate of more than 50% is diagnosed in 6-7% of critically ill patients. There is an objective need to Investigate methods of intensive therapy for refractory septic shock.The objective of the study: to analyze literature data on the intensive care of refractory septic shock.Results. The second part of the article analyzes 37 studies, both Russian and foreign ones devoted to the intensive care of refractory shock. At present, based on the analysis of the publication, it is impossible to draw reasonable conclusions about the advantage of one or another method of intensive therapy for refractory shock (veno-venous hemofiltration, the use of angiotensin II and vasopressin, as well as methylene blue, vitamin B12, ECMO) over basic therapy.
Highlights
the shock that does not respond to vasopressor therapy
more than 50% is diagnosed in 6-7% of critically ill patients
foreign ones devoted to the intensive care of refractory shock
Summary
Refractory shock is the shock that does not respond to vasopressor therapy. Refractory shock with a short-term mortality rate of more than 50% is diagnosed in 6-7% of critically ill patients. Исследования эффективности высокообъемной гемофильтрации с целью коррекции нарушений обмена веществ и элиминации медиаторов воспаления у пациентов с септическим шоком показали благоприятное влияние на гемодинамические показатели, но не на смертность. Снижение дозы NEP + EP на 50% в течение 24 ч после первого сеанса гемофильтрации продемонстрировали 30 (58%) пациентов (ранние респондеры), а 22 ‒ умерли от рефрактерного шока за тот же период времени.
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