METHOD FOR INCREASING THE EFFICIENCY OF INTENSIVE THERAPY IN SEVERE-BURNED AND EXTREMELY SEVERE-BURNED Russian patent published in 2021 - IPC A61M1/34 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to efferent therapy, combustiology, anesthesiology and resuscitation, and can be used to increase the effectiveness of intensive therapy for severely burned and extremely severely burned. To do this, against the background of combined extracorporeal detoxification in the first period of burn disease in the presence of the following symptoms: persistent hypotension with a decrease in mean arterial pressure to less than 65 mm Hg. against the background of adequate infusion therapy and an increase in the level of endotoxin activity of ≥0.6 or the identification of gram-negative flora according to the bacteriological study of biological media, selective adsorption of lipopolysaccharide is carried out or prolonged hemodiafiltration is used in the first period in the presence of one or the following indications: acute kidney damage of stage 2 or acute kidney damage of stage 1 in the presence of acute respiratory distress syndrome or clinical and laboratory signs of shock, or in the first period of burn disease in the presence of liver failure in the patient with SOFA score 2-4 points "liver" without a tendency to regress against the background of intensive conservative the therapy is carried out by selective plasma filtration; in the second and third periods of burn disease, measures are taken for the first period, but instead of prolonged hemodiafiltration, prolonged hemodiafiltration is used, while in the presence of severe hypernatremia, which is more than 155 mmol/l, not amenable to conservative correction, renal replacement therapy is performed; In all periods of burn disease in severely burned and extremely severely burned patients with signs of burn or septic shock, the above measures of the algorithm are supplemented with selective sorption of cytokines until blood pressure stabilizes.

EFFECT: method makes it possible to avoid the development of an unfavorable outcome in the most dangerous periods of burn disease due to the early differentiated use of methods of extracorporeal detoxification as part of intensive therapy, taking into account the staged course of the burn disease and the severity of organ dysfunctions.

1 cl, 1 ex