Early initiation of polymyxin B-immobilized fiber therapy effective for septic shock after aortic replacement.
A 76-year-old female underwent ascending aorta and partial arch replacement. She developed septic shock on postoperative day 6. She was administered dopamine, 10 microg x kg(-1) x min(-1); dobutamine, 5 microg x kg(-1) x min(-1); and norepinephrine, 0.3 microg x kg(-1) x min(-1). However, the blood pressure was 74/40 mmHg. Direct hemoperfusion using polymyxin B-immobilized fiber (PMX-DHP) was started; 3 h later, the blood pressure increased to 118/54 mmHg. Norepinephrine was stopped, and dopamine and dobutamine doses were decreased to 5 microg x kg(-1) x min(-1) 3 and 12 h after completing PMX-DHP, respectively. In suspected septic shock, early PMX-DHP simultaneously with drug treatment facilitates hemodynamic improvement.
Murakami
Masanori
M
Department of Cardiovascular Surgery, Shakaihoken Tokuyama Central Hospital, Shunan, Japan.
Miyauchi
Yoshitoyo
Y
Nishida
Masahiko
M
Okada
Haruhiko
H
Hamano
Kimikazu
K
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk / Q000601:surgery; D005260:Female; D006801:Humans; D011112:Polymyxin B / Q000627:therapeutic use*; D011183:Postoperative Complications; D012772:Shock, Septic / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D011112:Polymyxin B