• 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, Yoshimasa Otani, Yoshihiro Endo, Yutaka Eguchi, Tohru Tani, and PMX Treatment Study Group.
• 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.

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