Changes in circulating levels of calcitonin gene-related peptide and nitric oxide metabolites in septic patients during direct hemoperfusion with polymyxin B-immobilized fiber.
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.
Shimizu
Tomoharu
T
PMX Hemodynamics Study Group, Shiga University of Medical Science, Shiga, Japan.
Hanasawa
Kazuyoshi
K
Tani
Tohru
T
Endo
Yoshihiro
Y
Kurumi
Yoshimasa
Y
Ikeda
Toshiaki
T
Fujita
Naohiro
N
Morita
Hiroyuki
H
Imaizumi
Hitoshi
H
Sato
Takashi
T
Katayama
Hiroshi
H
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
D014662:Vasoconstrictor Agents; D009569:Nitric Oxide; D011112:Polymyxin B; D015740:Calcitonin Gene-Related Peptide