title: Plasmapheresis in the treatment of primary septic shock in humans.
abstract: 14 patients (mean age 25.5 yrs) with life-threatening primary septic shock were eligible for treatment with acute plasmapheresis in a prospective study. They had a short history of sepsis and had no severe underlying disease. 10/14 patients had systemic meningococcal disease. All patients were severely ill with a mean APACHE II score of 25.0. 12/14 patients were treated with plasmapheresis exchanging 1 plasma volume within hours of admission. 11/14 patients survived without major sequelae and 3 (21%) died of irreversible septic shock. This mortality is lower than that predicted from the APACHE II scores (55.2%). A subgroup of plasmapheresis-treated patients with septic shock and extensive petechiae were compared to a historical control group. The mortality in the treatment group was 1/7 (14%) versus 8/21 (38%) in the control group. We conclude that acute plasmapheresis may be a therapeutic option in the early stages of severe primary non-surgical septic shock.
authors.affiliation: Department of Infectious Diseases, Danderyd Hospital, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Gårdlund
authors.forename: J
authors.initials: J
authors.lastname: Sjölin
authors.forename: A
authors.initials: A
authors.lastname: Nilsson
authors.forename: M
authors.initials: M
authors.lastname: Roll
authors.forename: C J
authors.initials: CJ
authors.lastname: Wickerts
authors.forename: B
authors.initials: B
authors.lastname: Wikström
authors.forename: B
authors.initials: B
authors.lastname: Wretlind
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003422:Critical Care; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*; D011446:Prospective Studies; D012772:Shock, Septic / Q000401:mortality / Q000628:therapy*