Sołtysiak Jolanta, Bartkowska-Śniatkowska Alicja, Rosada-Kurasińska Jowita, Lipkowska Katarzyna, Zachwieja Jacek
Department of Paediatric Nephrology and Cardiology, Poznań University of Medical Sciences, Poland.
Anaesthesiol Intensive Ther. 2014 Apr-Jun;46(2):92-5. doi: 10.5603/AIT.2014.0018.
The mortality rate for severe sepsis and septic shock remains high. Additionally, this life-threatening state poses serious difficulties for the treatment of patients. Unfortunately, the mechanism of sepsis is complex and not well understood. In this paper, we present the case of a 2.5-year-old female with septic shock treated with plasma exchange (PE) as a nonstandard therapy. We analysed the medical history of disease, including patient data, physical examination, laboratory tests and treatment. Unexpectedly, we achieved clinical improvement after the first PE. During PE, the dose of catecholamine was reduced. In addition, the level of C-reactive protein seemed to be a better predictor of the efficacy of PE in septic shock compared to procalcitonin. We conclude that PE may improve the survival rate for patients with septic shock. These data could be useful in the search and introduction of new or alternative methods of treatment for critically ill children.
严重脓毒症和脓毒性休克的死亡率仍然很高。此外,这种危及生命的状态给患者的治疗带来了严重困难。不幸的是,脓毒症的机制复杂,尚未得到充分了解。在本文中,我们介绍了一例2.5岁患脓毒性休克的女性患者,接受了血浆置换(PE)这种非标准疗法的治疗。我们分析了疾病病史,包括患者数据、体格检查、实验室检查和治疗情况。出乎意料的是,首次血浆置换后我们实现了临床改善。在血浆置换期间,儿茶酚胺的剂量减少了。此外,与降钙素原相比,C反应蛋白水平似乎是脓毒性休克中血浆置换疗效的更好预测指标。我们得出结论,血浆置换可能提高脓毒性休克患者的生存率。这些数据可能有助于寻找和引入针对危重症儿童的新的或替代治疗方法。