title: Direct hemoperfusion with polymyxin B-immobilized fiber improves shock and hypoxemia during endotoxemia in anesthetized sheep.
abstract: This study evaluates the effect of direct hemoperfusion (DHP) using polymyxin B-immobilized fibers (PMX-F) as an extracorporeal blood filter on systemic hypotension and lung injury during endotoxemia Sheep were anesthetized, intubated, mechanically ventilated with 50% oxygen and connected to the DHP system between the right femoral artery and left jugular vein. Group 1 (n = 6)sheep were infused with 10 microg/kg Escherichia coli endotoxin over a 30 min period. At the same time, sheep underwent DHP with PMX-F (Toraymyxin: PMX-20R) for 2 h at a flow rate of 60 ml/h. Group 2 (n = 6) sheep were infused with the same dose of endotoxin and treated with a sham column, in the same manner as those in group 1. DHP with PMX-F significantly improved and restored systemic pressure and arterial oxygen tension in group 1 sheep, although these values never returned to the baseline levels of group 2 sheep. Pulmonary hypertension and leukocytopenia were observed after endotoxin infusion in both groups, but there were no significant differences between these values. DHP with PMX-F significantly decreased the elevation of plasma nitric oxide products. The treatment with PMX-F improves shock and deteriorated oxygenation during endotoxemia, probably through the suppression of nitric oxide production.
authors.affiliation: First Department of Medicine and Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Koizumi
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Kaneki
authors.forename: Keisaku
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Keishi
authors.initials: K
authors.lastname: Kubo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Honda
mesh_terms: D000768:Anesthesia, General / Q000662:veterinary; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D004195:Disease Models, Animal; D019446:Endotoxemia / Q000150:complications / Q000188:drug therapy* / Q000662:veterinary; D004927:Escherichia coli Infections / Q000150:complications / Q000188:drug therapy* / Q000662:veterinary; D006464:Hemoperfusion / Q000379:methods*; D006976:Hypertension, Pulmonary / Q000209:etiology; D000860:Hypoxia / Q000188:drug therapy* / Q000209:etiology; D007970:Leukopenia / Q000209:etiology; D009569:Nitric Oxide / Q000378:metabolism; D011112:Polymyxin B / Q000008:administration & dosage* / Q000494:pharmacology*; D012756:Sheep; D012769:Shock / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D009569:Nitric Oxide; D011112:Polymyxin B