Diagnosis of Multiorgan Failure Syndrome in Patients With Disseminated Peritonitis

Resume. The aim of the study was to highlight aspects of multiple organ failure syndrome in patients with disseminated peritonitis. Matherials and methods. The study included 124 patients with toxic and terminal stages of peritonitis, who were divided into three groups: Group I consisted of 39 (31.4%) patients, whose complex treatment was supplemented with cytochrome C; Group II consisted of 41 (33.1%) patients, whose complex treatment was supplemented with CS and a solution containing levocarnitine and arginine hydrochloride; the comparison group consisted of 44 (35.5%) patients, in whom the above-mentioned drugs were not used. The activity of oxidant-antioxidant reactions in patients with peritonitis during the course of the disease was studied. Results. In patients of group I on the 7th day of the study, the level of diene conjugates was (2.97±0.10) standard units, ROS — (2.45±0.11) μmol/ml, S-nitrosothiols — (1.30±0.08) nmol/ml, SOD — (0.20±0.01) units/mg protein, carbonyl groups — (4.72±0.78) μmol/l, sodium nitrite — (5.35±0.15) μmol/l. In patients of group II on the 7th day of the study, the level of diene conjugates was (1.71±0.23) standard units, ROS — (2.00±0.11) μmol/ml, S-nitrosothiols — (1.17±0.06) nmol/ml, SOD — (0.23±0.02) units/mg protein, carbonyl groups — (3.67±0.44) μmol/l, sodium nitrite — (5.17±0.19) μmol/l. In patients of the comparison group, decompensation in oxidantantioxidant reactions was determined. Conclusions. Determination of oxidant-antioxidant responses in the treatment of patients with toxic and terminal stages of peritonitis, as well as assessment of their condition using the SOFA and MODS scales allows choosing the right treatment tactics and is of great practical importance. The use of cytochrome C and a solution containing levocarnitine and arginine hydrochloride in the treatment of patients with widespread peritonitis contributes to the optimization of oxidant-antioxidant responses, which leads to a decrease in inflammation and improves treatment results.