title: Direct hemoperfusion with polymyxin-B-immobilized fiber columns improves septic hypotension and reduces inflammatory mediators in septic patients with colorectal perforation.
abstract: OBJECTIVE
  Although some studies have reported favorable effects of direct hemoperfusion with polymyxin-B-immobilized fiber columns (PMX) for the treatment of septic shock, few studies have demonstrated the efficacy of PMX in studies with a uniform case definition and without any other blood purification techniques.
  
  
  METHODS
  Fifty-two patients with severe sepsis or septic shock secondary to colorectal perforation were treated with PMX. Hemodynamic alterations and plasma concentrations of endotoxin, interleukin (IL)-1beta, IL-1 receptor antagonist (IL-1Ra), IL-6, IL-8, and IL-10 were evaluated following PMX treatment.
  
  
  RESULTS
  We observed a significant reduction in plasma endotoxin in the nonsurvivors immediately after PMX treatment compared to before treatment. Systolic blood pressure was markedly increased and circulating levels of IL-1beta, IL-1Ra, and IL-8 were significantly reduced during a 2-h interval of PMX.
  
  
  CONCLUSIONS
  Our findings suggested that PMX treatment appears to adsorb endotoxin and also modulates circulating cytokine during a 2-h interval of direct hemoperfusion in septic patients with such condition.
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Hanasawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
authors.forename: Masahiko
authors.initials: M
authors.lastname: Umeki
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Koga
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Naganuma
authors.forename: Seiji
authors.initials: S
authors.lastname: Sato
authors.forename: Tomonori
authors.initials: T
authors.lastname: Shimonishi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Naoto
authors.initials: N
authors.lastname: Matsuno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Saitoh
authors.forename: Koshi
authors.initials: K
authors.lastname: Satoh
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Otani
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Endo
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Tani
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D003108:Colonic Diseases / Q000276:immunology / Q000601:surgery*; D016207:Cytokines / Q000097:blood; D004731:Endotoxins / Q000097:blood; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D007022:Hypotension / Q000276:immunology / Q000628:therapy*; D018836:Inflammation Mediators / Q000097:blood*; D007416:Intestinal Perforation / Q000276:immunology / Q000601:surgery*; D008297:Male; D011112:Polymyxin B / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012002:Rectal Diseases / Q000276:immunology / Q000601:surgery*; D018805:Sepsis / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D012772:Shock, Septic / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate
chemical_list: D000900:Anti-Bacterial Agents; D016207:Cytokines; D004731:Endotoxins; D018836:Inflammation Mediators; D011112:Polymyxin B