Manifestations of dengue fever - arthralgia, respiratory failure, organ disorders, haemorrhage with thrombocytopenia - are largely determined by heavy endotoxicosis with increased permeability of the vascular endothelium with the release from the vascular bed in tissues of not only fluid but also protein. It develops a toxic edema of the lungs that leads to respiratory distress with severe respiratory failure, in the liver - to toxic hepatopathy, in the brain - a toxic encephalopathy. Toxins damage the membranes of platelets, contributing to their increased adhesive activity with the formation of microaggregates, which is the first phase of development of disseminated intravascular clotting syndrome with thrombocytopenia and hemorrhagic manifestations (skin - hemorrhagic rash, stomach - vomiting blood, kidneys - oligouria and hematuria, etc.).
As there is no specific treatment, and the disease is potentially fatal, especially for children, detoxification is virtually the only method of treatment. In this case, transfusion therapy alone is not able to withdraw all formed endotoxins. A fuller effect can be reached by plasmapheresis, which in severe cases should be carried out in the mode of plasma exchange, when removed plasma is replaced with fresh frozen donor plasma. Thisprovidesnotonlydetoxification, butalsorestorationoftheimmunedefenseandhemostasissystem.
The use of Russian device "Hemofenix", which has a small filling volume, presents an opportunity to perform plasmapheresis, not only in large medical centers, but also in the field in cases of mass illnesses in hospitals of municipal level. Simplicity and safety of membrane plasmapheresis allows its use in critical conditions, up to cases with unstable hemodynamics, including children.