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Timočki medicinski glasnik
2018, vol. 43, br. 3, str. 118-131
jezik rada: srpski
vrsta rada: prikaz
objavljeno: 01/02/2019
doi: 10.5937/tmg1803118J
Sepsa i akutno oštećenje bubrega - patofiziološki mehanizmi i osnovni principi lečenja
aMedicines and medical devices agency of Serbian, Belgrade
bHealth center Zaječar, Department of nephrology and hemodialysis, Zaječar
cKlinički centar Kragujevac, Klinika za urologiju, nefrologiju i dijalizu + Univerzitet u Kragujevcu, Medicinski fakultet
dMedical center Tutin, Center of hemodialysis, Tutin
eUniverzitet u Kragujevcu, Medicinski fakultet
fUniverzitet u Kragujevcu, Medicinski fakultet + Klinički centar Kragujevac, Klinika za infektivne bolesti

e-adresa: jacovic.sasa@gmail.com

Projekat

Analiza strukture troškova i uticaja na zdravstveni budžet Republike Srbije epidemiološki najmasovnijih i/ili najskupljih oboljenja i procena odnosa troškovi / efektivnost / korisnost medicinskih intervencija (MPNTR - 175014)

Sažetak

Sepsa je glavni uzrok razvoja akutnog oštećenja bubrega kod kritičnih bolesnika u jedinicama intenzivne nege. Pojačani i nekontrolisani odgovor imunološkog sistema domaćinana bakterijske infekcije ima značajn uulogu u patogenezi akutnog oštećenja bubrega kod pacijenata sa sepsom. Ključnu ulogu u lečenju bolesnika s sepsomima rana ciljana terapija, rana primena antibiotika, optimalna kontrola mesta infekcije i terapija zamene renalne funkcije. Modaliteti kontinuiranog dijaliznog lečenja su indikovani kod hemodinamski nestabilnih bolesnika s teškom sepsom, septičkim šokom i akutnim oštećenjem bubrega. Kontinuiranaveno-venska hemodijafiltracija sa modifikovanom AN69ST membranom obezbedjuje homeostazu reakcije imunološkog sistema na bakterijske infekcije, hemodinamisku stabilnost bolesnika, poboljšanu funkciju bubrega i veću stopu preživljavanja kod pacijenata sa septičkim šokom i akutnom bubrežnom slabošću.

Ključne reči

sepsa; akutno oštećenje bubrega; patofiziološki mehanizmi; terapija zamene bubrežne funkcije

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