title: Time to initiation of treatment with polymyxin B cartridge hemoperfusion in septic shock patients.
abstract: BACKGROUND
  We investigated whether early initiation of hemoperfusion with a polymyxin B cartridge (PMX) after the diagnosis of septic shock could improve the clinical outcome.
  
  
  METHODS
  A prospective, open-labeled, multicenter cohort study was performed at intensive care units in Japan. 41 patients received PMX within 6 h after the diagnosis of septic shock (early group) and 51 patients were treated after 6 h (late group).
  
  
  RESULTS
  The early group had a significantly shorter duration of ventilator support and also had a lower catecholamine requirement. PMX was effective for improvement of hypotension, hypoperfusion, the sequential organ failure assessment score, and pulmonary oxygenation regardless of the timing of its initiation. The 28-day mortality rate did not differ between the two groups.
  
  
  CONCLUSIONS
  Early initiation of PMX shortened the duration of ventilator support and also reduced the catecholamine requirement, so early treatment of septic shock should achieve a better outcome.
authors.affiliation: Department of Emergency and Acute Intensive Care Medicine, Fujita Health University, Toyoake, Aichi 470-1192, Japan. takeyama@fujita-hu.ac.jp
authors.forename: Naoshi
authors.initials: N
authors.lastname: Takeyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Noguchi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Hirakawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Kano
authors.forename: Kazuma
authors.initials: K
authors.lastname: Morino
authors.forename: Toru
authors.initials: T
authors.lastname: Obata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Tamai
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ishikura
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kase
authors.forename: Makoto
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Toshio
authors.initials: T
authors.lastname: Naka
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002395:Catecholamines / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D007022:Hypotension / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011112:Polymyxin B / Q000627:therapeutic use*; D011446:Prospective Studies; D012772:Shock, Septic / Q000628:therapy*; D016019:Survival Analysis; D012122:Ventilators, Mechanical
chemical_list: D000900:Anti-Bacterial Agents; D002395:Catecholamines; D011112:Polymyxin B