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Список литературы

  1. Бочоришвили В.Г. Сепсисология с основами инфекционной па- тологии. Тбилиси: Мецниереба, 1988.
  2. Войно-Ясенецкий В.Ф. Очерки гнойной хирургии. СПб.; М.: Невский диалект, 2000.
  3. Интенсивная терапия. Под ред. В.Д. Малышева. М.: Медици- на, 2002.
  4. Костюченко А.Л., Гуревич К.Я., Лыткин М.И. Интенсивная терапия послеоперационных осложнений. СПб.: Спецлит, 2000.
  5. Раны и раневые инфекции. Под редакцией М.И. Кузина и Б.М. Костюченко. М.: Медицина, 1990.
  6. Руководство по неотложной хирургии органов брюшной полос- ти. Под ред. В.С. Савельева. М.: Триада-Х, 2004.
  7. Руководство по хирургическим инфекциям. Под ред. И.А. Ерю- хина, Б.Р. Гельфанда, С.А. Шляпникова. СПб.: Питер, 2003.
  8. Alejandria M.M., Lansang M.A., Dans L.F., Mantaring J.B.V. Intravenousimmunoglobulin for treating sepsis and septic shock (Cochrane Review). In: The Cochrane Library, Issue 2002, 4. Oxford: Update Software.
  9. American Society of Parenteral and Enteral Nutrition Board of Directions. Guidelines for the use of parenteral and enteral nutri- tion in adult and paediatric patients. J Parent. Enter Nutr. 1993; 17: 1SA—26SA.
  10. Annane D., Sebille V., Charpentier C., et al. Effect of treatment with low doses hydro-cortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288: 862—871.
  11. Bauer T.T., Monton C., Torres A. Comparison of systemic cytokine levels in patients with acute respiratore distress syndrome, severe pneumonia, and controls. Thorax 2000; 55 (1): 46—52.
  12. Ben-Menachem T., Fogel R., et al.: Prophylaxis for stess-related gastric hemorrhage in the medical intensive care unit: a ran- domized, controlled, single-blind study. Ann Intern Med. 1994; 121: 568—575.
  13. Bernard G. R., Vincent J.-L., Laterre P.-E, et al. The Recombinant Human Activated Protein С Worldwide Evaluation in Severe Sepsis (PROWESS) Study Group Efficacy and Safety of Recombinant Human Activated Protein С for Severe Sepsis. N Engl J Med. 2001; 344: 699—709.
  14. Bernard G.R. Drotrcogin alfa (activated) (recombinant human activated protein C) for the treatment of severe sepsis. Crit. Care Med. 2003; 31 (1 Suppl): S85—89.
  15. Boldt J., Muller M., Mentges D., et al. Volume therapy in the cri- tically ill: is there a difference? Intensive Care Med. 1998; 24: 28—36.
  16. Bone R.C. A personal experience with SIRS and MODS. Crit. Care Med. 1996; 24 (8): 1417—1418.
  17. Bone R.C. Pathogenesis of sepsis Ann Intern Med. 1991; 115: 457—469.
  18. Bone R.C. Sepsis and controlled clinical trials: the odyssey (edito- rial; comment) Crit. Care Med. 1995; 23 (7): 1165—1166.
  19. Bone R.C. Sepsis, the sepsis syndrome, multi-organ failure: a plain for comparable definitions Ann. Intern. Med. 1991; 114: 332-333.
  20. Bone R.C. Sir Isaac Newton, sepsis, SIRS and Care. Crit. Care Med. 1996; 24 (7): 1125—1128.
  21. Bone R.C. Toward a theory regarding the pathogenesis of the sys- temic inflammatory response syndrome: What we do and do not know about cytokine regulation. Crit. Care Med. 1996; 24: 163—170.
  22. Bone R.C., Balk R.A., Cerra F.B. Definitions for sepsis and organ failure and guide-lines for the use of innovative therapies in sep- sis: the ACCP/SCCM consensus conference committee Chest 1992; 101: 1644—1655.
  23. Bonten M.J.M., Froon A.H.M., Gaillard C.A., et al. The Systemic Inflammatory Response in the Development of Ventilator- Associated Pneumonia AM J RESPIR Crit. Care Med. 1997; 156: 1105—1113.
  24. Caswell J.L., Middleton D.M., Sorden S.D., Gordon J.R. Expression of the neutrophil chemoattractant interleukin-8 in the lesions of bovine pneumonic pasteurellosis. Veterinary Pathology 1998; 35 (2): 124—131.
  25. Chollet-Martin S., Montravers P, Gibert C., et al. High levels of interleukin-8 in the blood and alveolar spaces of patients with pneumonia and adult respiratory distress syndrome Infect. Immun. 1993; 61 (11): 4553—4559.
  26. Cole L., Bellomo R., Hart G., et al. A phase II randomized, con- trolled trial of continuous hemofiltration in sepsis. Crit. Care Med. 2002; 30: 100—106.
  27. Cole L., Bellomo R., Hart G., et al. A phase II randomized, con- trolled trial of continuous hemofiltration in sepsis. Crit. Care Med. 2002; 30: 100—106.
  28. Cundell D.R., Weiser J.N., Shen J., et al. Relationship between colonial morphology and adherence of Streptococcus pneumo- niae. Infect Immun. 1995; 63: 757—761.
  29. Danner R.L., Elin R.I., Hoseini I.M., et al. Endotoxin determina- tions in 100 patients with septic shock Clin. Res. 1988; 36: 453.
  30. De Werra I., Jaccard C., Corradin S. Cytokines, nitrite/nitrite, sTNF, and procalcitonin concentratinsxomparisons in patients with septic shock, cardiogenic shok, bacterial pneumonia. Crit. Care Med. 1997; 25: 607—613.
  31. Dehoux M.S., Boutten A., Ostinelli J., et al. Compartmentalized cytokine production within the human lung in unilateral pneu- monia. Am J Respir. Crit. Care Med. 1994; 150: 710—716.
  32. Dellinger R.P., Bone R.C. To SIRS with love. Crit. Care Med. 1998; 26 (1): 178.
  33. Dellinger R.R: Cardiovascular management of septic shock. Crit. Care Med. 2003; 31: 946—955.
  34. Dobb G.J. Multiple organ faillure-«words mean what it say they mean» Intensive Care World 1991; 8: 157—159.
  35. Dunham C.M. Clinical impact of Continuous Renal Replacement Therapies on МОЕ World JSurg. 2001.
  36. Efferen L.S. Update on Renal Replacement Techniques: After Prevention, What Works? http//:www.medscape.com Oct. 10, 2003.
  37. Eichacker P.Q., Gerstenberger E.P., Banks S.M., et al.: Meta- analysis of acute lunginjury and acute respiratory distress syn- drome trials testing low tidal volumes. Am J Respir. Crit. Care Med. 2002; 166: 1510—1514.
  38. Fox-Dewhurst R., Alberts M., Kajikawa O., et al. Pulmonary and systemic inflammatory responses in rabbits with Gram-negative pneumonia. Am J Respir. Crit. Care Med. 1997; 155: 2030—2040.
  39. Frevert C.W. The inflammatory response of gram-negative pneu- monia and its relation to clinical disease.
  40. Frevert C.W., Huang S., et al. Functional characterization of the rat chemokine KС and its importance in neutrophil recruitment in a rat model of pulmonary inflammation. J Immunol. 1995; 154: 335—344.
  41. Gardlund В., and Heparin Prophylaxis Study Group: A rando- mized, controlled trial of low-dose heparin for prevention of fatal pulmonary embolism in patients with infections diseases. Lancet 1996; 347: 1357—1361.
  42. Gattinoni L., Togoni G., et al. Effect of pron positioning on the sur- vival of patients with acute respiratory failure. N Engl J Med. 2001; 345: 568—573.
  43. Gibot S., Cariou A., Drouet L., et al. Crit. Care Med. 2002; 30: 969—973.
  44. Gourang P., Patel, David P. Gurka and Robert A. Balk: New treatment strategies for severe sepsis and septic shock. Curr Opin Crit. Care 2003; 9: 390—396.
  45. Gramm H.J., Dollinger P., Beier W. Procalcitonin - ein neuer mark- er der inflamatorischen. Chir. Gastroenterol. 1995; Il, 2: 51—54.
  46. Green G.M. The role of the alveolar macrophage in the clearance of bacteria from the lung. J. Exp. Med., 1964; 119: 167—175.
  47. Hakansson A., Kidd A., Wadell G., et al. Adenovirus infectionen- hances the in vitro adherence of Streptococcus pneumoniae. Infect. Immun. 1994; 62: 2707—2714.
  48. Hauser A.R., Cobb E., Bodi M., et al. Crit. Care Med. 2002; 30 (3): 521—528.
  49. Heath L., Chrisp C., Huffnagle G., et al. Effector mechanisms responsible for gamma interferon-mediated host resistance to Legionella pneumophila lung infection: the role of endogenous nitric oxide differs in susceptible and resistant murine hosts. Infect. Immun. 1996; 64: 5151—5160.
  50. Heering P., et al. Cytokine removal and cardiovascular hemody- namics in septic patients with CWH. Int Care Med. 1997; 23 (3): 288—296.
  51. Kelley J. Cytokines of the lung. Am Rev. Respir. Dis. 1990; 141: 765—788.
  52. Knaus W.A., et al. APACHE II: A severity of disease classifica- tion system. Crit. Care Med. 1985; 13: 818—829.
  53. Kobayashi A., Hashimoto S., Kooguchi K., et al. Expression of inducible nitric oxide synthase and inflammatory cytokines in alveolar macrophages of ARDS following sepsis. Chest 1998; 113: 1632—1639.
  54. Kollinga U.K., Hansena F., Brauna J., et al. Leucocyte response and anti-inflammatory cytokines in community acquired pneu- monia. Thorax 2001 (February); 56: 121—125.
  55. Kolls J.K., Lei D., Nelson S., et al. Exacerbation of murine P carinii infection by aden-oviral-mediated gene transfer of a TNF soluble receptor. Am J Respir. Crit. Care Med. 1995; 151: 13.
  56. Kopko P.M., Marshall C.S., Mackenzie M.R. Transfusion-related acute lung injury. JAMA 2002; 287: 1968—1971.
  57. Kurahashi K., Kajikawa O., Sawa T., et al. Pathogenesis of septic shock in Pseudomonas aeruginosa pneumonia. J Clin. Invest. 1999; 104 (6): 743—750.
  58. Kuse E.R., Langefeld I., Jaeger K. Procalcitonin — a new diag- nostic tool in complications following liver transplantation. Intensive Care Med. 2000; 2: 187—192.
  59. Le Gall J.R., et al. A new simplified acute physiology score (SAPS II) based on a European. North American multicenter study. JAMA 1993; 270: 2957—2963.
  60. Levy M.M., Fink M.P., Marshall J., et al. 2001 SCCM/ESICM/ ACCP/ATS/SIS International Sepsis Definitions Conference Crit. Care Med. 2003; 31: 1250—1256.
  61. MacLean A., Wei X.Q., Huang F.P., et al. Mice lacking inducible nitric-oxide synthase are more susceptible to herpes simplex virus infection despite enhanced Thl cell responses. J Gen Virol. 1998; 79: 825—830.
  62. MacMicking J.D., North R.J, LaCourse R., et al. Identification of nitric oxide synthase as a protective locus against tuberculosis. Proc Natl Acad Sci USA 1997; 94: 5243—5248.
  63. Malyak M., Smith M.F., Abel A.A., et al. Peripheral blood neu- trophil production of interleukin-1 receptor antagonist and inter- leukin-1 beta. J Clin. Immunol. 1994; 14: 20—30.
  64. Marik P.R., Zaloga G.P. Adrenal insufficiency in the critically ill. Chest 2002; 122: 1784—1796.
  65. Martin C., Viviand X., Leone M., et al. Effect of norepinephrine on the outcome of septic shock. Crit. Care Med. 2000; 28: 2758—2765.
  66. Martin C., Viviand X., Leone M., et al. Crit. Care Med. 2000; 28: 2758—2765.
  67. Maus U., Rosseau S., Knies U., et al. Expression of pro-inflamma- tory cytokines by flow-sorted macrophages in severe pneumonia. EurRespir J 1998; 11: 534—541.
  68. Meduri G.U., Headley S., Kohler G., et al. Persistent elevation of inflammatory cytokines predicts a poor outcome in ARDS. Chest 1995; 107: 1062—1073.
  69. Medzhitov R., Janeway C.A., Jr. Аn ancient system of host defense. Curr Opin Immunol. 1998; 10 (1): 12—15.
  70. Meisner M. Procalcitonin. A new innovative infection parameter. Biochemical and clinical aspects. 2000 Georg Thieme Verlag. Stuttgart—New York.
  71. Monton C., Torres A., El-Ebiary M., et al. Cytokine expression in severe pneumonia: a bronchoalveolar lavage study. Crit. Care Med. 1999.
  72. Moussa K., Michie H.J., Cree I.A., et al. Phagocyte function and cytokine production in community-acquired pneumonia. Thorax 1994; 49: 107—111.
  73. Nelson S., Mason C.M., Kolls J., et al. Pathophysiology of pneu- monia. Clin. Chest Med. 1995; 16: 1—12.
  74. Nelson S., Noel P., Bokulic R., et al. Murine recombinant tumor necrosis factor enhances pulmonary host defense against Staphylococcus aureus. Am Rev. Respir. Dis. 1989; 139: 357.
  75. Noble D.W. Proton pump inhibitors аnd stress ulcer prophylaxis: pause for thought? Crit. Care Med. 2002; 30 (5): 1175—1176.
  76. Pastrick P., Webster K., et al. Noninvasive positive-pressure ven- tilation in acute respiratory distress syndrome without prior chronic respiratory failure. Am J Resp. Crit. Care Med. 1996; 153: 1005—1011.
  77. Pfeffer K., Matsuyama T., Kundig T.M., et al. Mice deficient for the 55 kd tumor necrosis factor receptor are resistant to endo- toxic shock, yet succumb to L. Monocytogenes infection. Cell 1993; 73: 457—467.
  78. Pinhu L., Whitehead T., Evans Т., et al. Ventilator associated lung injury. Lancet 2003; 361: 332—340.
  79. Practice parameters for hemodynamic support of sepsis in adult patients in sepsis. Task force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit. Care Med. 1999; 27: 639.
  80. Pugin J., Heumann I.D., Tomasz A., et al. CD14 is a pattern reco- gnition receptor. Immunity 1994; 1 (6): 509—516.
  81. Rackow E.C., Falk J.L., Fein I.A., et al. Fluid resuscitation in cir- culatory shock: a comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypo- volemic and septic shock. Crit. Care Med. 1983; 11: 839—850.
  82. Riesenfeld-Orn I., Wolpe S., Garcia-Bustos J.F., et al. Production of interleukin-1 but not tumor necrosis factor by human mono- cytes stimulated with pneumococcal cell surface components. Infect. Immun. 1989; 57: 1890—1893.
  83. Rivers E., Nguyen В., Havstad S., et al. Early goal-directed thera- py in the treatment of severe sepsis and septic shock. N Engl J Med. 2001; 345: 1368—1377.
  84. Rolfe M.W., Kunkel S.L., Standiford T.J., et al. Pulmonary fibro- blast expression of interleukin-8: a model for alveolar macrophage-derived cytokine networking. Am. J Respir. Cell Molecular Biology 1991; 5 (5): 493—501.
  85. Ronco C., et al. A pilot study of coupled plasma filtration with adsorption in septic shock. Crit. Care Med. 2002; 30 (6): 1250—1255.
  86. Rottenberg M.E., Gigliotti Rothfuchs A.C., Gigliotti D., et al. Role of innate and adaptive immunity in the outcome of primary infection with Chlamydia pneumoniae, as analyzed in genetical- ly modified mice. J Immunol. 1999; 162: 2829—2836.
  87. Sackett D.L: Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 1989; 95: 2—4.
  88. Saint S., Matthay M. Risk reduction in intensive care unit. Am J Med. 1998; 105: 515—523.
  89. Sasaki S., Miura T., Nishikawa S., et al. Protective role of nitric oxide in Staphylococcus aureus infection in mice. Infect. Immun. 1998; 66: 1017—1022.
  90. Saukkonen K., Sande S., Qoffe C., et al. The role of cytokines in the generation of inflammation and tissue damage in experimental gram-positive meningitis. J Exp. Med. 1990; 171: 439—448.
  91. Sha W., Liou H., Tuomanen E., et al. Targeted disruption of the p50 subunit of NF-kВ leads to multifocal defects in immune responses. Cell 1995; 80: 321—330.
  92. Shellito J.E., Kolls J.K., Olariu R., et al. Nitric oxide and host defense against Pneumocystis carinii infection in a mouse model. J Infect Dis. 1996; 173: 432—439.
  93. Siegel J.P.: Assessing the use of activated protein С in the treat- ment of severe sepsis. N Engl J Med. 2002; 347: 1030—1034.
  94. Singh S., Wort S.J., Evans T.W. Inducible nitric oxide and pul- monary infection Thorax 1999; 54: 959—960.
  95. Stewart Т.Е.: Controversies around lung protective mechanical ventilation. Am J Respir. Crit. Care Med. 2002; 166: 1421—1422.
  96. Stuber R., Petersen M., Bokelmann R., et al. Crit. Care Med. 1996; 24: 381—384.
  97. Stuehr D.J., Kwon N.S., Gross S.S., et al. Synthesis of nitrogen oxides from L-arginine by macrophage cytosol: requirement for inducible and constitutive components. Biochem. Biophys. Res Commun. 1989; 161: 420—426.
  98. Takala A., Jousela I., Olkkola K., et al. SIRS without systemic inflammation in acutely ill patients admitted to hospital in a medicfl emergency. Clin. Sci 1999; 96: 287—295.
  99. Taniguchi T., Koido Y., Aiboshi J., et al: Change in the ratio of IL- 6 to IL-10 predicts a poor outcome with patients SIRS Ctit. Care Med. 1999; 27: 1262—1264.
  100. Taylor R.W., Manganaro L., O'Brien J., et al.: Impact of allogenic packed red blood cell transfusion on nosocomial infection rates in critically ill patient. Crit. Care Med. 2002; 30: 2249—2254.
  101. The Acute Respiratory Distress Syndrome Network: Ventilation with lower tidal volumes as compared with traditional tidal vo- lumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000; 342: 1301—1308.
  102. Tomasz A., Saukkonen K. The nature of cell wall-derived inflam- matory components of pneumococci. Pediatr Infect. Dis. J 1989; 8: 902—903.
  103. Tsai W.C., Strieter R.M., Wilkowski J.M., et al. Lung-specific transgenic expression of KС enhances resistance to Klebsiella pneumoniae in mice. J Immunol., 1998; 161 (5): 2435—2440.
  104. Tuomanen E., Hengstler B., Rich R., et al. Nonsteroidal anti- inflammatory agents in the therapy for experimental pneumo- coccal meningitis. J Infect. Dis. 1987; 155: 985—990.
  105. Tuomanen E., Liu H., Hengstler B., et al. The induction of meningeal inflammation by components of the pneumococcal cell wall. J Infect. Dis. 1985; 151: 859—868.
  106. Tuomanen E., Rich R., Zak O. Induction of pulmonary inflamma- tion by components of the pneumococcal cell surface. Am Rev. Respir. Dis. 1987; 135: 869—874.
  107. Tuomanen E.I., Austrian R., Robertmasure H. Pathogenesis of pneumococcal infection. The new england journal of medicine May 11, 1995; 332 (191): 280—284.
  108. Ueda S., Nishio K., Minamino N., et al. Increased plasma levels of adrenomedullin in patients with SIRS. Am J Respir. Crit. Care Med. 1999; 160: 132—136.
  109. Van den Berghe G., Wouters P.J., Boruillon R., et al. Outcome be- nefit of intensive insulin therapy in critically ill: insulin dose ver- sus glycemic control. Crit. Care Med. 2003; 31: 359—366.
  110. Van der Poll T., van Deventer S.J., ten Cate H., et al. Tumor necro- sis factor is involved in the appearance of interleukin-1 receptor antagonist in endotoxinemia. J Infect. Dis. 1994; 169: 665—667.
  111. Villard J., Dayer-Pastore F., Hamacher J., et al. GRO alpha and interleukin-8 in Pneumocysis carinii or bacterial pneumonia and adult respiratory distress syndrome. Am. J Respir. Crit. Care Med. 1995; 152: 1549—1554.
  112. Vincent J.-L. Dear SIRS, I'm sorry to say that I don't like you. Crit. Care Med. 1997; 25: 372—374.
  113. Vincent J.-L. Hemodynamic support in sepsis shock. Intens. Care Med. 2001; 27 (suppl.): 80—89.
  114. Wheeler A.P., Bernard G.R. Treating patients with severe sepsis. N Engl J Med. 1999; 40: 207—214.
  115. Wheeler M.A., Smith S.D., Garcia-Cardena G., et al. Bacterial infection induces nitric oxide synthase in human neutrophils. J Clin. Invest. 1997; 99: 110—116.
  116. Zimmerman I.I., Ringer T.V. Inflammatory responses in sepsis Crit. Care Clin. 1992; 8: 163—189.

Хирургическое лечение сепсиса

И. А. Ерюхин, С. А. Шляпников, Н. А. Ефименко, A. M. Светухин

В общем смысле принципы хирургического вмешательства на очагах инфекции, столь ярко и образно представленные в классических трудах В. Ф. Войно-Ясенецкого и постоянно совершенствующиеся в ведущих специализированных клиниках, достаточно хорошо известны практическим хирургам, однако для методических рекомендаций, способных принести реальную пользу, этого мало. Необходимо объективное, статистически-корректное обоснование, полученное в условиях рандомизированного проспективного исследования, и здесь-то и возникают значительные трудности. Они связаны с неоднородностью клинических ситуаций, развивающихся в условиях тяжелого сепсиса и требующих нестандартных клинических решений, разнообразие которых превышает численность типовых вариантов любого из перечисленных выше методов интенсивной терапии и даже их совокупности. Вместе с тем и отказ от обобщения установок, если они ориентированы на принципы доказательной медицины, а не на отдельные, пусть даже показательные примеры из практики, по понятным причинам неуместен.

С учетом вышеуказанных замечаний в качестве исходной позиции для подготовки предлагаемых методических рекомендаций, регламентирующих хирургическую тактику, нами были использованы главные системообразующие и композиционные подходы, составляющие основу решения научно- практической задачи.

На основе критериев доказательной медицины обсуждаются и оцениваются решения клинических задач посредством трех типовых разновидностей хирургического вмешательства:

  • дренирование гнойных полостей;
  • удаление очагов инфицированного некроза;
  • удаление внутренних источников контаминации — колонизированных имплантатов (искусственных клапанов сердца, сосудистых или суставных протезов), инородных тел, временно с лечебной целью внедренных в ткани или внутренние среды организма (трубчатых дренажей и катетеров), а также удаление или проксимальное отключение (отведение) потока содержимого дефектов полых органов, рассматриваемых в качестве источников инфицирования.