• Tomoharu Shimizu, Kazuyoshi Hanasawa, Koichi Sato, Masahiko Umeki, Nobuhiko Koga, Tatsushi Naganuma, Seiji Sato, Tomonori Shimonishi, Toshiaki Ikeda, Naoto Matsuno, Satoshi Ono, Hitoshi Saitoh, Koshi Satoh... more , Yoshimasa Otani, Yoshihiro Endo, Yutaka Eguchi, Tohru Tani, and PMX Treatment Study Group. less
• Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
• Langenbecks Arch Surg. 2009 Mar 1;394(2):303-11.

PurposeAlthough some studies have reported favorable effects of direct hemoperfusion with polymyxin-B-immobilized fiber columns (PMX) for the treatment of septic shock, few studies have demonstrated the efficacy of PMX in studies with a uniform case definition and without any other blood purification techniques.Materials And MethodsFifty-two patients with severe sepsis or septic shock secondary to colorectal perforation were treated with PMX. Hemodynamic alterations and plasma concentrations of endotoxin, interleukin (IL)-1beta, IL-1 receptor antagonist (IL-1Ra), IL-6, IL-8, and IL-10 were evaluated following PMX treatment.ResultsWe observed a significant reduction in plasma endotoxin in the nonsurvivors immediately after PMX treatment compared to before treatment. Systolic blood pressure was markedly increased and circulating levels of IL-1beta, IL-1Ra, and IL-8 were significantly reduced during a 2-h interval of PMX.ConclusionsOur findings suggested that PMX treatment appears to adsorb endotoxin and also modulates circulating cytokine during a 2-h interval of direct hemoperfusion in septic patients with such condition.

46 keywords...

hide…