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Objectification of the stratification criteria in children with appendicular peritonitis for the selective hemoperfusion using the hemosorbent «Hemo-proteazsorb»

Peritonitis treatment in children remains one of the most complicated and urgent problem of modern surgery and intensive care. Particular attention is paid to therapy aimed to remove proinflammatory mediators and toxic substances. Hemoperfusion (HP) is a method based on elimination of toxic substances of an endogenous or exogenous nature from the patient’s blood by extracorporeal perfusion of whole blood through a special sorbent. However, to date, there are no clear clinical and laboratory criteria for the initiation, prolongation or completion of the HP procedure. Purpose – to objectify the stratification criteria in children with appendicular peritonitis for the selective HP using the hemosorbent «Hemo-proteazsorb». Materials and methods. The retrospective analysis of data from 60 patients with appendicular peritonitis was provided. Discriminant analysis was used. Results. Stratification criteria based on clinical and laboratory parameters of patients have been developed for HF procedure. Conclusions. The proposed scheme allows to stratify patients with appendicular peritonitis for the HP procedure. It makes possible to control the results of HP manipulation and allows to make decision whether to continue or complete treatment using the HP. Considering different capabilities of medical institutions, we recommend using the proposed method after validation of the results in these institutions. The study was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee. The informed consent of the parents for the research was obtained. No conflict of interest was declared by the authors. Key words: acute appendicitis, peritonitis, children, extracorporeal hemocorrection, hemoperfusion.