title: Changes in circulating levels of calcitonin gene-related peptide and nitric oxide metabolites in septic patients during direct hemoperfusion with polymyxin B-immobilized fiber.
abstract: OBJECTIVE
  This study evaluated the mechanism of hemodynamic improvement in polymyxin B-immobilized fiber (PMX) treatment.
  
  
  METHODS
  Fifteen septic patients with endotoxemia and/or gram negative infection were treated with PMX. Plasma concentrations of calcitonin gene-related peptide (CGRP) and nitric oxide metabolites were measured.
  
  
  RESULTS
  CGRP and nitric oxide metabolites before treatment were significantly higher than in healthy controls. CGRP had a significantly inverse correlation with diastolic blood pressure and a positive correlation with the Septic Severity Score and the number of failed organs. Systolic and diastolic blood pressure and systemic vascular resistance index increased significantly both immediately after and 24 h after PMX treatment. CGRP decreased significantly 24 h after the treatment. In contrast, there were no significant changes in nitric oxide metabolites.
  
  
  CONCLUSIONS
  PMX treatment improved hemodynamic parameters in septic patients, and CGRP increased with increasing severity of sepsis. We conclude that a decrease in CGRP levels may be related to hemodynamic improvement resulting from PMX treatments.
authors.affiliation: PMX Hemodynamics Study Group, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Hanasawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Tani
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Endo
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kurumi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Naohiro
authors.initials: N
authors.lastname: Fujita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Imaizumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Sato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katayama
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015740:Calcitonin Gene-Related Peptide / Q000097:blood*; D005260:Female; D006439:Hemodynamics; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D009569:Nitric Oxide / Q000097:blood* / Q000378:metabolism; D011112:Polymyxin B; D018805:Sepsis / Q000097:blood / Q000628:therapy*; D012720:Severity of Illness Index; D014655:Vascular Resistance; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014664:Vasodilation
chemical_list: D014662:Vasoconstrictor Agents; D009569:Nitric Oxide; D011112:Polymyxin B; D015740:Calcitonin Gene-Related Peptide