ИСТИНА

Sepsis and septic shock in patients with primary brain damage of different origin can lead to or aggravate the existing cerebral and focal neurologic symptoms due to cytokine storm imparing the hematoencephalic barrier. The development of septic shock in the setting of low cerebral perfusion pressure aggravates the cerebral damage, which may become irreversible, leading to negative outcome or death. In clinical situations described above the extracorporeal detoxication therapy may represent a valid therapeutic option, as it aims at elimination of substances, such as cytokines, lipopolysaccharides and other PAMPS from the systemic blood flow. In neurosurgical patients with septic shock it is feasible to use a combined approach, consisting of cytokine adsorption and continuous renal replacement therapy (CRRT) with increased sorption capacity membranes. Of note, the combination of these different methods has the potential to eliminate a wider spectrum of various substances from the blood flow in the maximally short time. In this study we present a case series, describing septic shock patients after neurosurgical interventions being treated with a combined extracorporeal detoxication therapy, including CRRT and cytokine adsorption.