COMPARATIVE ANALYSIS OF HAEMODYNAMICS AND HYDROBALANCE PARAMETERS MEASURED WITH PICCO MONITORING DURING CONTINUOUS VENO-VENOUS HAEMOFILTRATION AND HAEMODIAFILTRATION IN PATIENTS WITH SEVERE SEPSIS AND MULTIPLE ORGAN DYSFUNCTION

Background. Hemodynamic instability constantly occurs in the case of severe sepsis with multiple organ dysfunction. Aim. To identify and compare the peculiarities of haemodynamics and hydrobalance changes by PiCCO monitoring during continuous veno-venous haemofiltration (CVVHF) and continuous veno-venous haemodiafiltration (CVVHDF) in severe sepsis with MODS. Materials and methods. 36 sessions of continuous methods of RRT (14 – CVVHF and 22 – CVVHDF) in patients with multiple organ dysfunction syndrome associated with sepsis were under analysis. Central hemodynamic parameters were measured using the PiCCO apparatus (Pulsion, Germany). We studied the SBP, CVP, SI, GEDI and ELWI. Results.The use of CVVHF did not lead to the changes in hemodynamic parameters and hydrobalance. CVVHDF inclusion into the complex intensive therapy resulted in the decrease of GEDI from 806.5 (692.0; 956.0) to 617.5 (514.0; 631.0) mL/m2, ELWI from 10.4 (9.0; 12.0) to 6.0 (5.0; 7.0) mL/kg, as well as CVP from 8.1 (7.0; 9.0) to 6.0 (5.0; 6.0) mm Hg. At the same time changes in SBP and SI were not registered. Conclusion. The use of the CVVHF procedure did not lead to significant changes in CHD and hydrobalance within 24 hours of the session. Inclusion of CVVHDF resulted in reduced GEDI and ELWI, as well as CVP, with no changes in SBP and SI.