Despite significant progress in the treatment of peritonitis, the rates of postoperative mortality continue to remain high. In 90-95% of cases, mortality is somehow associated with endogenous intoxication, which is the cause of the development of multi-organ and multisystem failure in these patients. Optimization, pathogenetic substantiation and improvement of methods of extra- and intracorporeal correction during operations and postoperative management of severe peritonitis taking into account the violation of detoxification function of the lungs become a vital necessity and represent an urgent task for modern anesthesiology and surgery, requiring new scientifically based solutions, and detailed clarification of the above-mentioned issues will improve methods of prediction, early diagnosis of these complications and will contribute to the development of a more effective treatment of these complications.