The effect of extracorporeal efferent detoxication (EED) methods inclusion in the severe XXXX ( @entity497 ) treatment.

@entity1 @entity497 @entity8769
PURPOSE: To assess the clinical efficacy including of EED methods in the treatment of severe @entity497 with @entity8769 . MATERIAL AND METHODS: Severe @entity497 in @entity1 (n = 103, aged 18-60 years, male 89%) were randomly subdivided into the 4 comparable groups. The 1st group (n = 30) was standard treated with antibiotics. The 2nd group (n = 27) underwent additionally 3 courses of extracorporeal ultraviolet light-exposure (UVLE). The 3rd group (n = 25) was co-treated with 3 courses of biospecific hemosorption (BSS). The 4th group (n = 21) underwent 2 additional courses of BSS plus 3 courses of UVLE. The effectiveness of these schemes therapy was assessed by clinical and laboratory data. RESULTS: The additional application of EED methods led to faster disappearance of clinical symptoms, focal chest signs and the infiltrate resolution in chest X-ray (CXR) as compared with standard treatment. Mean time of the disappearance of fever and sweating was 2.2; 2.5; 2.0 days and 4.8; 5.0; 4.6 days in the 2nd, 3rd and 4th group respectively after EED courses vs 6.1 and 8.0 days in 1st group (P < 0.05). The baseline elastase activity was elevated by 5 times in the 1st-4th groups vs the control (healthy) group and was decreased by 1.5; 2.1; 4.1; 6.6 times respectively (P < 0.05) after treatment in these groups. The initial trypsin-like activity was increased about 5.5 times in all groups vs control and decreased after therapy by 2.1; 3.8; 6.4; 6.0 times (P < 0.05) in the 1st-4th groups respectively. Small CXR residual changes persisted in 7, 4 and 5 @entity1 from the 2nd, 3rd and 4th groups vs 12 @entity1 in the 1st group. The spirometry data were normalized faster in the @entity1 who underwent EED methods (by the 14th day) vs the 1st group. CONCLUSIONS: Additional using of EED methods in severe @entity497 therapy is more effective (as compared with traditional management with antibiotics only) in term of faster improvement of @entity1 general condition, reduced time of inflammatory infiltrate resolution and hospitalization by 3-4 days. It has been shown that EED methods correct the main pathogenic mechanisms of severe @entity497 . Our results indicated on the EED methods as an attractive supportive therapy for the empiric antibiotics treatment of this disease.
