title: Hemoperfusion with an immobilized polymyxin B fiber column reduces circulating interleukin-8 concentrations.
abstract: In the present study, we examined whether the performance of hemoperfusion with an immobilized polymyxin B fiber column (DHP-PMX) reduces circulating interleukin-8 concentration in patients with sepsis. Fifteen patients with sepsis satisfying the following criteria were enrolled in the study: (i) signs of systemic inflammatory response syndrome caused by infection; and (ii) mean arterial blood pressure > or =60 mm Hg (irrespective of the use of catecholamines). A thermodilution catheter was inserted prior to DHP-PMX for appropriate intravenous infusion, and the DHP-PMX was carried out twice at 24 h intervals (for 3 h each time). Circulating interleukin-8 concentration was measured seven times. The sequential organ failure assessment (SOFA) score was calculated twice. Circulating interleukin-8 concentration was 55 +/- 15.7 pg/mL before DHP-PMX, while it was 101 +/- 58.8 pg/mL immediately after the first session of treatment. It was 24 +/- 9.0 pg/mL before the second session of DHP-PMX, and it was 28 +/- 8.0 pg/mL immediately after the second session. The IL-8 level was 17 +/- 4.3 pg/mL at 48 h afterward, and 18 +/- 4.3 pg/mL at 72 h afterward, showing a significant decrease from 48 h onwards, compared with before treatment (P < 0.05). The SOFA score was 9 +/- 1.5 and the APACHE II score was 19 +/- 2.0 before DHP-PMX, while the SOFA score was 7.0 +/- 0.9 at 72 h afterward, showing a significant decrease compared with before treatment (P < 0.05). The present findings indicate that DHP-PMX indirectly reduces circulating interleukin-8 concentration and improves SOFA score.
authors.affiliation: Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo, Japan. hkushi@med.nihon-u.ac.jp
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Kushi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Miki
authors.forename: Jun
authors.initials: J
authors.lastname: Nakahara
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Kawahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saito
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Tanjoh
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000737:chemistry* / Q000494:pharmacology; D005260:Female; D006464:Hemoperfusion / Q000379:methods; D006801:Humans; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011112:Polymyxin B / Q000737:chemistry* / Q000494:pharmacology; D011446:Prospective Studies; D012121:Respiration, Artificial; D018805:Sepsis / Q000097:blood* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D016209:Interleukin-8; D008567:Membranes, Artificial; D011112:Polymyxin B