Effect of an endotoxin-removing column containing immobilized polymyxin B fiber in a patient with septic shock from gram-positive infection.
A 67-yr-old patient with septic shock caused by gram-positive infection fell into circulatory collapse. Direct hemoperfusion with an endotoxin-removing column was then carried out for 120 min. As a result, blood pressure and systemic vascular resistance increased significantly during this therapy. Cardiac output changed from hyperdynamic to normodynamic, and plasma endotoxin level decreased. After this treatment, the patient recovered. From this experience, we consider that the endotoxin-removing column may be effective for septic shock patients.
Iwama
H
H
Trauma and Critical Care Center, Central Aizu General Hospital, Aizuwakamatsu, Japan.
Komatsu
T
T
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D004731:Endotoxins / Q000037:antagonists & inhibitors / Q000097:blood; D016908:Gram-Positive Bacterial Infections / Q000628:therapy*; D006464:Hemoperfusion / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D011112:Polymyxin B / Q000008:administration & dosage / Q000627:therapeutic use*; D012772:Shock, Septic / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014655:Vascular Resistance / Q000502:physiology
D000900:Anti-Bacterial Agents; D004731:Endotoxins; D007375:Interleukin-1; D007376:Interleukin-2; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D011112:Polymyxin B; D010100:Oxygen