Efficacy of postoperative polymyxin B hemoperfusion in secondary peritonitis patients with septic shock: a propensity-matched analysis.
BACKGROUND
Severe sepsis and septic shock is still a challenge. Polymyxin B hemoperfusion (PMX) is a device designed to remove circulating endotoxin by adsorption, which is reported to improve treatment outcomes. This study aimed to further verify the efficacy of PMX on postoperative, peritonitis, septic shock patients.


METHODS
This study prospectively analyzed 20 of 155 patients who presented with postoperative septic shock and were treated with PMX in a single institute during the period March 2013 to September 2014 (Clinical Trial Protocol number: ChiCTR-ONC-16008160). A control group (53 patients) was recruited from our own 2012 database using the propensity-matching score method. The data collection includes demographic data, postoperative organ dysfunction status, disease severity and treatment result.


RESULTS
The 2 groups (treatment vs. control) were similar in demographic data, organ dysfunction status and disease severity. PMX use provides benefits for recovery of hemodynamic status and many other aspects, including better survival, but is not statistically significant. For survival factor analysis, PMX use is also not significant for patient survival in our study.


CONCLUSIONS
PMX provided some benefits to patients in the treatment for peritonitis septic shock. An improvement in hemodynamic status was mostly observed. Our study also supports the finding that PMX used as an auxiliary treatment provides improved survival but is not statistically significant, possibly due to the small sample size with multiple comorbidities.
 Division of Trauma and Emergency Surgery, Department of Surgery, Chang-Gung Memorial Hospital, Taipei - Taiwan.
Kuo-Ching
KC
Yuan
 Division of Trauma and Emergency Surgery, Department of Surgery, Chang-Gung Memorial Hospital, Taipei - Taiwan.
Shang-Yu
SY
Wang
 Division of General Surgery, Department of Surgery, Chang-Gung Memorial Hospital, Taipei - Taiwan.
Ming-Chin
MC
Yu
 Division of Trauma and Emergency Surgery, Department of Surgery, Chang-Gung Memorial Hospital, Taipei - Taiwan.
Yu-Pao
YP
Hsu
 Division of Nephrology, Department of Medicine, Keelung Chang Gung Memorial Hospital, Keelung City - Taiwan.| Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taipei - Taiwan.
Heng-Chih
HC
Pan
 Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taipei - Taiwan.| Chang Gung University College of Medicine, Taoyuan - Taiwan.
Yung-Chang
YC
Chen
D000327:Adsorption; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006439:Hemodynamics; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000628:therapy*; D011112:Polymyxin B / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000628:therapy; D011184:Postoperative Period; D012772:Shock, Septic / Q000628:therapy*; D016896:Treatment Outcome
D011112:Polymyxin B