Effect of polymyxin B-immobilized fiber hemoperfusion on respiratory impairment, hepatocellular dysfunction, and leucopenia in a neonatal sepsis model.
OBJECTIVE
Sepsis and septic shock remain a major source of morbidity and mortality in neonates despite advances in antimicrobials and aggressive supportive care. Our aim was to study the effects of polymyxin-B direct hemoperfusion (PMX-DHP) therapy on sepsis-induced respiratory impairment, liver dysfunction and leucopenia in a neonatal cecal ligation and perforation (CLP) model.


METHODS
Fourteen anesthetized and mechanically ventilated 3-day-old piglets underwent CLP and an arteriovenous extracorporeal circuit from 3 h until 6 h post-CLP, with a PMX column in the PMX-DHP treated group (7 piglets). Changes in oxygen saturation, PCO(2), base excess, white blood cell (WBC) count, platelet count, hematocrit (Hct%), serum glutamate pyruvate transaminase (SGPT), and serum glutamic oxaloacetic transaminase were measured before CLP and at 1, 3 and 6 h after.


RESULTS
At 6 h, the PMX-DHP group showed lower Hct%, and SGPT in comparison to the control group, but higher oxygen saturation and WBC count. No effects on the platelet count were found. The survival times of the PMX-DHP group were longer than in control.


CONCLUSIONS
PMX-DHP therapy limited the respiratory impairment, liver dysfunction and leucopenia in a neonatal septic model, which resulted in an improvement of survival time.
Department of Pediatrics Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan. drmhamed@yahoo.com
Mohamed Hamed
MH
Hussein
Ghada A
GA
Daoud
Hiroki
H
Kakita
Shin
S
Kato
Tatenobu
T
Goto
Michi
M
Kamei
Kenji
K
Goto
Yasuhiko
Y
Ozaki
Tetsuya
T
Ito
Sumio
S
Fukuda
Ineko
I
Kato
Satoshi
S
Suzuki
Takashi
T
Hashimoto
Hajime
H
Togari
D000818:Animals; D000831:Animals, Newborn; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D020099:Coated Materials, Biocompatible; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006464:Hemoperfusion / Q000379:methods*; D022781:Hepatocytes / Q000473:pathology; D007970:Leukopenia / Q000378:metabolism / Q000628:therapy*; D008107:Liver Diseases / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D010101:Oxygen Consumption; D011112:Polymyxin B / Q000494:pharmacology*; D011137:Polystyrenes; D012131:Respiratory Insufficiency / Q000378:metabolism / Q000628:therapy*; D018805:Sepsis / Q000378:metabolism / Q000628:therapy*; D013552:Swine; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D011137:Polystyrenes; D011112:Polymyxin B