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The objective: to study in vitro adsorption properties of various devices for selective lipopolysaccharide (LPS) adsorption.Subjects and Methods: Various methods of closed circuit circulating bovine serum endotoxin solutions were used. The serum was perfused using an LPS sorption device for 240 min. Serum samples were collected before the start of perfusion, and 30, 60, 120, 150, and 240 minutes after the start of circulation. LPS concentrations were measured by the turbidimetric method. One column for polymyxin hemoperfusion and three devices for selective adsorption of lipopolysaccharides were assessed.Results: When using the device for polymyxin hemoperfusion, the concentration of endotoxin in bovine serum decreased by 61% during 120 minutes, and in 120 minutes after additional administration of endotoxin, it went down by 57%. When using the other three devices, these parameters made 9% and 6%, 10% and 8%, 5% and 10%, respectively. Conclusion. By definition, an in vitro study cannot provide for complex pathophysiological reactions occurring in the body during sepsis. Тhis fact leads to limitations in extrapolating the results obtained to clinical practice.

Of all cases of acute kidney injury (AKI), 45-70% are associated with sepsis. Lethality in sepsis-associated AKI requiring renal replacement therapy (RRT) ranges from 40 to 50%, and in AKI combined with other organ dysfunctions - 60-80%. In order to improve the results of treatment of sepsis and septic shock, various methods of extracorporeal detoxification (ECD) have been developed. The effectiveness of these methods is controversial. In the treatment of sepsis, RRT is used not only to replace the impaired detoxification function of kidneys, but also to remove excess cytokines from the systemic bloodstream. The literature describes mainly positive results of the use of dialyzers with an adsorbing membrane, however, these data do not have the necessary degree of evidence. Currently, there are no clear criteria for the initiation of RRT, its duration and doses, the choice of methodology determined by specific clinical and laboratory parameters, and staging of this therapy. All this highlights the need for further research in this field.

The effectiveness of antibacterial therapy is a critical factor to improve treatment outcomes in sepsis patients. Impaired renal function and renal replacement therapy lead to a significant change in the pharmacokinetic parameters of most intravenous antibacterial drugs, which in many cases is accompanied by insufficient or excessive concentration in the blood which results in antibacterial therapy failure. The article presents current views and describes the current problems of antibacterial therapy for sepsis during the use of extracorporeal detoxification methods.The objective: to analyze publications on antibacterial therapy of sepsis during the extracorporeal detoxification.Results: the most accessible and effective method for solving the problem of inadequate dosage of antibiotics when using extracorporeal detoxification is to develop local protocols based on the results of pharmacokinetic studies.

Goal of the review: to build up the current understanding of electrophysiological specific features of various neuromuscular blockades. Having analyzed the results of multiple studies devoted to investigation of the impact of various medications including inhalation anesthetics on the neuromuscular neurility, the authors summarized the current opportunities to monitor neuromuscular blockade. It has been noted that the data for blockade monitoring when using traditional neuromuscular blocking agents are studied much better compared to the drugs providing the other types of blockade.

In Ukraine the incidence of acute pancreatitis is 102 per 100 000 population. In recent years researches in the field of the methods of diagnostics of disease severity showed that one of the most promising is determination of the concentration of procalcitonin in blood. The experience of application hemodiafiltration was described In the literature. The purpose of the research: to analyze the results of treatment of patients with destructive forms of acute pancreatitis with the use of modern methods of diagnostics and treatment. Materials and methods. The study included 15 patients with destructive forms of acute pancreatitis. The severity of the patient's condition was evaluated by the scale APACHE II, the degree of multiple organ failure (MOF) by the scale SOFA, the degree of endogenous intoxication by assess of the leukocyte index of intoxication (LII) and concentration of procalcitonin. Results. Only 11 patients recovered, five had purulent-septic complications, which in one case led to a lethal outcome. Three patients admitted in the extremely pore condition of the disease with lethal outcome in connection with the development of shock and multiple organ failure. The highest values of procalcitonin corresponded to the maximum values of APACHE II and SOFA. Three patients received prolonged venous-venous hemodiafiltration and in two of them positive dynamics was got: decreased number of points by APACHE II ≤6,SOFA≤3, decreased LII ≤7 and concentration of procalcitonin, one became death. Conclusions. For the assessment of severity of disease it is necessary to determine the concentration of procalcitonin. In the complex intensive therapy the prolonged venous-venous hemodiafiltration use is justified.