[Choice of a method of extracorporeal detoxication in pyogenic peritonitis]

An experience of using discrete exchange plasmapheresis (DEP), filtration exchange plasmapheresis (FEP), hemofiltration (HF) and plasmafiltration (PF) in combination with ultraviolet (UV) irradiation of autoblood has been reviewed in 92 patients with pyogenic peritonitis. It has been shown that HF (PF) is an effective and pathogenetically grounded method of detoxication in patients with disseminated pyogenic peritonitis at a stage of polyorgan failure. FEP must be a method of choice during complex therapy at terminal phases of disseminated pyogenic peritonitis. The mechanisms of FEP therapeutic effect are based on elimination of a wide range of toxic substances, correction of severe metabolic disturbances, improvement of central and liver hemodynamics and, in combination with UV irradiation of autoblood, on bacteriocide and antihypoxic effect. The use of DEP is restricted to local pyogenic processes in the abdominal cavity.