Polymyxin B Direct Hemoperfusion Using Regional Citrate-Calcium Anticoagulation: A Case Report.
Direct hemoperfusion with polymyxin B (PMX-DHP) is an extracorporeal treatment to add to conventional therapy during unresponsive endotoxic septic shock. So far, only heparin has been used as an anticoagulant during polymyxin B therapy. We present a case report of a postsurgical septic patient treated with 2 cycles of PMX-DHP using citrate anticoagulation. Monitoring of serum calcium, postcartridge calcium, and acid-base balance was performed. The treatments were accomplished without complications. To our knowledge, this is the first published report on the use of citrate anticoagulation during PMX-DHP. We conclude that citrate anticoagulation is feasible during hemoperfusion therapy in patients with increased hemorrhagic risk.
From the *Department of Anesthesia and Intensive Care, University of Pisa, Pisa, Italy; †McGill University, Montreal, Canada; and ‡Department of Anesthesia and Intensive Care, University of Udine, Udine, Italy.
Anna
A
Sidoti
Etrusca
E
Brogi
Joshua
J
Morse
Michele
M
Collareta
Luigi
L
Vetrugno
Francesco
F
Giunta
Francesco
F
Forfori
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D002118:Calcium / Q000097:blood; D002122:Calcium Chloride / Q000008:administration & dosage / Q000627:therapeutic use*; D019343:Citric Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011112:Polymyxin B / Q000627:therapeutic use*; D012772:Shock, Septic / Q000097:blood / Q000628:therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D019343:Citric Acid; D011112:Polymyxin B; D002122:Calcium Chloride; D002118:Calcium