PREDICTING THE POSSIBILITY OF DEVELOPING MULTIORGAN DEFICIENCY SYNDROME IN PATIENTS WITH PERITONITIS

Abstract

Study Objective: To determine the feasibility of predicting the development of multiple organ dysfunction syndrome (MODS) in children with peritonitis based on an analysis of blood coagulation (hemostasis) parameters.

Materials and Methods: The study included 52 children aged 6 to 18 years admitted to the surgical department of the Tashkent State Medical University, with a diagnosis of peritonitis confirmed during surgery. Patients were divided into three groups:

• Group I (22 children): with localized peritonitis.


• Group II (22 children): with generalized peritonitis but without obvious clinical and laboratory signs of sepsis (with one or two signs of a systemic inflammatory response).


• Group III (8 children): with generalized peritonitis and pronounced clinical and laboratory signs of sepsis.

Results: Initial analysis showed that all patients with peritonitis had increased blood coagulation compared to normal. Further observation of the disease revealed the following:

• Children in Group I successfully managed peritonitis thanks to the therapy administered, and they did not develop POES.


• In Group II, POES developed in 10% of patients, and in 50% of patients in Group III. In cases of POES development, a change in treatment strategy was required.

Conclusion: A study of the blood coagulation system in children with peritonitis allowed us to identify three types of the body's response to abdominal infection:

• Favorable type: characterized by the absence of POES and the presence of no more than two signs of a systemic inflammatory response.


• Questionable type: accompanied by the development of POES in 10% of cases, with no more than two signs of a systemic inflammatory response.


• Unfavorable type: associated with the development of POES in 50% of cases and the presence of more than two signs of a systemic inflammatory response, indicating abdominal (peritoneal) sepsis.