[Usefulness of endotoxin removal from the septic blood with direct hemoperfusion using PMX-F].
Sepsis and septic shock have been drugs difficult to treat despite many our therapeutic methods. There are many drugs for sepsis, but few can remove or detoxify such sabstances as endotoxin. The polystyrene fiber immobilized polymyxin B (PMX-F) have been invented and it was already confirmed the stability of its bonding. In this paper, mass-productive PMX-F for the clinical application were estimated.


METHODS
PMX-F adsorbed endotoxin (10ng/ml) from the calf serum, and recombinant tumor necrosis factor (80U/ml) from the serine solution. PMX-F maintained an antimicrobial activities against E.coli sufficiently. Those activities of PMX-F showed significant difference between PMX-F and carrier fiber. But PMX-F could not adsorb histamine and thromboxane B2. In vivo studies: The treatment of endotoxic mongrel dogs showed early recovery in arterial blood pressure, and ameliorated survival rate significantly. In human study, 77-year old male patients who had obstructive jaundice due to recurrent stomach cancer and biliary tract infection by Klebsiella showed sepsis and DIC. During DHP with PMX-F, the change of blood pressure was remarkable better, and platelet counts decreased, but next morning this count recovered completely and he had no hemorrhagic tendency. We believe clinical application of PMX-F is safe and useful.
Tani
T
T
Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
Hanasawa
K
K
Kodama
M
M
D000327:Adsorption; D000368:Aged; D000818:Animals; D004285:Dogs; D004731:Endotoxins / Q000097:blood*; D006464:Hemoperfusion; D006801:Humans; D008297:Male; D011112:Polymyxin B / Q000008:administration & dosage*; D011113:Polymyxins / Q000008:administration & dosage*; D012772:Shock, Septic / Q000188:drug therapy*
D004731:Endotoxins; D011113:Polymyxins; D011112:Polymyxin B