[The course and prognosis of septic shock in patients with hemoblastoses and aplastic anemia in a state of agranulocytosis].

The course and prognosis of septic shock developing during agranulocytosis were retrospectively studied in 59 hematological patients (52 ones with hemoblastosis and 7 with aplastic anemia). Out of 59 patients with septic shock hospitalized at department for anesthesiology and reanimation, in 5 shock was arrested and they were transferred to other departments of the hospital. All patients with failure of more than three organ systems, with SAPS score of 21 at admission, and a history of splenectomy died in the anesthesiology and reanimation department. The diagnosis of the underlying disease, resistance to chemotherapy administered, disease stage, persistent agranulocytosis, and artificial ventilation of the lungs which had to be resorted to did not influence the prognosis of septic shock. Even after effective antishock therapy all patients with aplastic anemia died, as did the patients with resistance to chemotherapy administered for the underlying disease and those without signs of granulocytopoiesis recovery. Hence, the prognosis is unfavorable for patients with septic shock in a state of agranulocytosis, if their SAPS score on admission is higher than 21, if they develop polyorgan failure with involvement of more than three organ systems, have a history of splenectomy, their hemoblastosis is resistant to chemotherapy, and there are no prospects for granulocytopoiesis recovery.