title: Changes in serum S100A12 and sRAGE associated with improvement of the PaO(2)/FiO(2) ratio following PMX-DHP therapy for postoperative septic shock.
abstract: BACKGROUND
  Endotoxin (Et) adsorption therapy with a column of polymyxin B-immobilized fibers (PMX) is effective in improving the partial pressure of arterial oxygen/fraction of inspired oxygen ratio (PaO(2)/FiO(2) ratio) and increasing mean arterial blood pressure (MAP) in sepsis. S100A12 and soluble receptor for advanced glycation end product (sRAGE) are useful as early markers of acute lung injury.
  
  
  OBJECTIVE
  To investigate the effect of improving the PaO(2)/FiO(2) ratio by PMX-direct hemoperfusion (PMX-DHP) on production of S100A12 and sRAGE.
  
  
  METHODS
  Sepsis patients after surgery for perforation of the lower gastrointestinal tract were adopted as the subjects. We retrospectively reviewed the cases of 20 patients on mechanical ventilation and continuous administration of norepinephrine. We recorded PaO(2)/FiO(2) ratio, MAP, and norepinephrine doses. S100A12, sRAGE, and Et levels were measured before and after PMX-DHP.
  
  
  RESULTS
  The PaO(2)/FiO(2) ratio and MAP improved significantly after PMX-DHP (p < 0.05). S100A12 and Et decreased significantly after PMX-DHP (p < 0.05). No differences were observed in sRAGE.
  
  
  CONCLUSIONS
  S100A12 is useful as a marker that reflected improvement in the PaO(2)/FiO(2) ratio after PMX-DHP. We consider PMX-DHP to be useful as adjunctive therapy for sepsis that reduces the Et and corrects the pathology in the early stage.
authors.affiliation: Department of Critical Care Medicine, Iwate Medical University, School of Medicine, Morioka, Japan.
authors.forename: G
authors.initials: G
authors.lastname: Takahashi
authors.forename: K
authors.initials: K
authors.lastname: Hoshikawa
authors.forename: N
authors.initials: N
authors.lastname: Matsumoto
authors.forename: T
authors.initials: T
authors.lastname: Shozushima
authors.forename: C
authors.initials: C
authors.lastname: Onodera
authors.forename: S
authors.initials: S
authors.lastname: Kan
authors.forename: S
authors.initials: S
authors.lastname: Akitomi
authors.forename: T
authors.initials: T
authors.lastname: Kikkawa
authors.forename: Y
authors.initials: Y
authors.lastname: Tomisawa
authors.forename: M
authors.initials: M
authors.lastname: Kojika
authors.forename: N
authors.initials: N
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
authors.forename: K
authors.initials: K
authors.lastname: Suzuki
authors.forename: G
authors.initials: G
authors.lastname: Wakabayashi
authors.forename: S
authors.initials: S
authors.lastname: Endo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004731:Endotoxins / Q000097:blood / Q000302:isolation & purification; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011112:Polymyxin B; D011183:Postoperative Complications / Q000097:blood / Q000628:therapy*; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D012189:Retrospective Studies; D009418:S100 Proteins / Q000097:blood*; D000067616:S100A12 Protein; D012772:Shock, Septic / Q000097:blood / Q000628:therapy*
chemical_list: D015415:Biomarkers; D004731:Endotoxins; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; D009418:S100 Proteins; D000067616:S100A12 Protein; C090441:S100A12 protein, human; D011112:Polymyxin B; D010100:Oxygen