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Klinicheskaya Meditsina 2003

[Clinical course and intensive therapy of sepsis in geriatric patients].

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R E Iakubtsevich
V V Spas
K M Dorokhin

Keywords

Abstract

A comparative analysis was performed of a clinical course and intensive therapy of sepsis in 43 patients over 60 years of age. 86% of them were patients aged 60 to 74 years, the rest were older. The intensive therapy included: surgical treatment of the infection focus (on demand), antibiotics, immunomodulators (immunoglobulins or interleukine-2 preparations), nonsteroid antiinflammatory drugs (diclofenak), inhibitors of tumor necrosis factor (pentoxiphilline), vitamins of group B, infusion therapy, parenteral feeding (on demand), plasmapheresis or biospecific antiproteinase hemosorption. It is shown that geriatric patients develop sepsis due to chronic therapeutic pathology, their condition at admission to hospital is more severe. They have a changed posture of red blood and insignificant leukocytosis though the eukocytic index of intoxication in them is much higher. Biochemical indices in sepsis are approximately the same in all the age groups except total protein. Cellular immunity in the elderly is hyperactive while humoral immunity is depressed. Aged patients have hyperkinetic circulation and bad oxygen blood transport. A complex of therapeutic measures minimized sepsis lethality in geriatric patients.

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