Thay huyết tương và lọc máu hấp phụ trong điều trị nhiễm khuẩn huyết có suy đa tạng, đông máu nội mạch rải rác liên quan nhiễm khuẩn huyết trong giai đoạn hậu sản: Trường hợp lâm sàng và đối chiếu y văn

Sepsis was a common medical condition with a high mortality rate when there was progressive Multiple Organ Dysfunction Syndrome (MODS). The evidence for therapeutic plasma exchange (TPE) is promising but inconclusive. The impact of TPE on short-term mortality in patients with organ dysfunction due to sepsis remains uncertain. Various techniques for extracorporeal hemodialysis can reduce elevated proinflammatory cytokine levels in septic shock, potentially reducing the severity of the systemic inflammatory response. Some methods are effective in removing endotoxins, especially sepsis caused by gram-negative bacteria, which can help stabilize the patient's condition. Case report: A 32-year-old female patient was hospitalized for jaundice in the postpartum period, diagnosed with sepsis, acute liver injury, acute kidney injury, and sepsis-associated disseminated intravascular coagulation. Sepsis was diagnosed according to Sepsis 3 criteria. AKI was defined according to the KDIGO classification. DIC was diagnosed according to the International Society on Thrombosis and Haemostasis (ISTH) score. The patient received standard treatment, in addition the patient received therapeutic plasma exchange, and continued hemoperfusion continuously for the next 3 days with 3 resin adsorbent cardrige. The patient improved liver and kidney function and recovered. Conclusions: Therapeutic Plasma Exchange and hemoperfusion should be considered in addition to standard treatment of patients with severe or unfavorable sepsis/septic shock. However, more large RCTs are needed to confirm the effectiveness of these techniques in sepsis/septic shock.