title: The effects of polymyxin B-immobilized fiber hemoperfusion on respiratory impairment in endotoxemic pigs.
abstract: OBJECTIVE
  This study investigated the effects of direct hemoperfusion with polymyxin B-immobilized fibers (PMX-DHP) on respiratory impairment in endotoxemic pigs.
  
  
  METHODS
  Thirteen anesthetized, mechanically ventilated pigs were divided into PMX-DHP (n=7) and control (n=6) groups. All pigs were hemodynamically monitored with the pulse index contour cardiac output (PiCCO) system (Pulsion Medical Systems, Munich, Germany) and infused intravenously with live Escherichia coli (LD50). In the PMX-DHP group, an arteriovenous extracorporeal circuit with a PMX column was applied for 30 to 150 minutes after endotoxin injection. We analyzed the laboratory data, arterial blood gas levels, and PiCCO variables (extravascular lung water [EVLW] and pulmonary vascular permeability index [PVPI]). Furthermore, we performed computed tomography of the chest in all pigs. The data were statistically analyzed with Student's t-test, the chi-square test, and the Mann-Whitney U-test.
  
  
  RESULTS
  With PMX-DHP endotoxemia significantly decreased and blood pressure increased 150 minutes after endotoxin injection. PiCCO revealed more cases of decreased EVLW in the PMX-DHP group. PVPI increased after endotoxin infusion in both groups. Computed tomography showed improvements in the PMX-DHP group. The survival rate was greater in the PMX-DHP group (100%) than in the control group (71%).
  
  
  CONCLUSIONS
  PMX-DHP is effective for treating respiratory impairment and contributes to the decreased mortality rate in the endotoxemic pigs.
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koami
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Taku
authors.initials: T
authors.lastname: Miyasho
authors.forename: Takaharu
authors.initials: T
authors.lastname: Itami
authors.forename: Jun
authors.initials: J
authors.lastname: Tamura
authors.forename: Tomohito
authors.initials: T
authors.lastname: Ishizuka
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Kozo
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kenjirou
authors.initials: K
authors.lastname: Miyoshi
authors.forename: Kazuto
authors.initials: K
authors.lastname: Yamashita
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004195:Disease Models, Animal; D019446:Endotoxemia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011112:Polymyxin B / Q000494:pharmacology*; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016019:Survival Analysis; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D011112:Polymyxin B