Clinical responses and improvement of some laboratory parameters following polymyxin B-immobilized fiber treatment in septic shock.
Direct hemoperfusion using a polymyxin B-immobilized fiber column (PMX; Toray Industries Inc., Tokyo, Japan) was first developed in 1994 and has since been used for the treatment of septic shock. Positive clinical data, such as an increase in systolic blood pressure (SBP) and an improved Pao2/Fio2 ratio, have also been reported. We treated 27 septic shock patients using DHP-PMX. The patients were separated into two groups for analysis: those whose Pao2/Fio2 ratio increased after DHP-PMX (9 cases) and those whose Pao2/Fio2 ratio did not increase after DHP-PMX (18 cases). The patients were also separated into two other groups for analysis: those whose SBP increased by more than 30 mm Hg immediately after DHP-PMX (15 cases) and those whose SBP did not increase by more than 30 mm Hg after DHP-PMX (12 cases). The Pao2/Fio2 ratio increased significantly after DHP-PMX in the groups showing improved 2AG and PAI-1 levels (p = 0.0040). The SBP increased significantly in the group showing improved HMGB-1 levels (p < 0.0001). We observed a relationship between hemodynamic improvement and increase of the serum HMGB-1 levels and between improvement of respiratory functions and increase of the serum 2-AG and PAI-1 levels in septic shock patients treated with DHP-PMX.
Sakamoto
Yuichiro
Y
Department of Emergency and Critical Care Medicine, Chiba-Hokusoh Hospital, Nippon Medical School, Inba-Gun, Chiba, Japan.
Mashiko
Kunihiro
K
Obata
Toru
T
Matsumoto
Hisashi
H
Hara
Yoshiaki
Y
Kutsukata
Noriyoshi
N
Yamamoto
Yasuhiro
Y
D018806:APACHE; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001095:Arachidonic Acids / Q000097:blood*; D001794:Blood Pressure / Q000187:drug effects; D063388:Endocannabinoids; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005989:Glycerides / Q000097:blood*; D024243:HMGB1 Protein / Q000097:blood*; D006464:Hemoperfusion / Q000379:methods; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011112:Polymyxin B / Q000627:therapeutic use*; D053284:Polyunsaturated Alkamides / Q000097:blood; D011486:Protein C / Q000032:analysis; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood / Q000628:therapy*; D021241:Spectrometry, Mass, Electrospray Ionization; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001095:Arachidonic Acids; D063388:Endocannabinoids; D005989:Glycerides; D024243:HMGB1 Protein; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; D053284:Polyunsaturated Alkamides; D011486:Protein C; C094503:glyceryl 2-arachidonate; D011112:Polymyxin B; C078814:anandamide