Polymyxin B-immobilized fiber hemoperfusion with the PMX-05R column in elderly patients suffering from septic shock.
BACKGROUND
Direct hemoperfusion with the polymyxin B-immobilized fiber (PMX-20R) column has a positive effect on outcome in patients with sepsis or septic shock. The PMX-05R column has a low priming volume and has been used in pediatric patients with septic shock. The aim of the present study was to determine whether PMX-F treatment with the PMX-05R column is effective in elderly patients with septic shock.


METHODS
We performed direct hemoperfusion twice with the PMX-05R column in 8 septic shock patients who were over 80 years of age. Five of the 8 patients survived. The 3 patients who died were undergoing hemodialysis for chronic renal failure, and methicillin-resistant Staphylococcus aureus was detected in all 3.


RESULTS
PMX-F treatment significantly increased systolic and diastolic blood pressures (P = 0.0004 for both) and significantly reduced heart rate (P < 0.0001), the blood endotoxin level (P = 0.0011), blood IL-6 level (P = 0.039), C-reactive protein level (P < 0.0001), and white blood cell count (P < 0.0001).


CONCLUSIONS
Direct hemoperfusion with the PMX-05R column is effective in ameliorating clinical and laboratory abnormalities in elderly septic shock patients.
Nakamura
Tsukasa
T
Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
Kawagoe
Yasuhiro
Y
Suzuki
Tsukasa
T
Shoji
Hisataka
H
Ueda
Yoshihiko
Y
Koide
Hikaru
H
D000367:Age Factors; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004731:Endotoxins / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006464:Hemoperfusion / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D011112:Polymyxin B / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012772:Shock, Septic / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D016019:Survival Analysis; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004731:Endotoxins; D015850:Interleukin-6; D002097:C-Reactive Protein; D011112:Polymyxin B