• Mohamed Hamed Hussein, Ghada A Daoud, Hiroki Kakita, Shin Kato, Tatenobu Goto, Michi Kamei, Kenji Goto, Yasuhiko Ozaki, Tetsuya Ito, Sumio Fukuda, Ineko Kato, Satoshi Suzuki, Takashi Hashimoto, and Hajime Togari.
• Department of Pediatrics Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan. drmhamed@yahoo.com
• Pediatr. Surg. Int. 2010 Feb 1;26(2):187-93.

PurposeSepsis and septic shock remain a major source of morbidity and mortality in neonates despite advances in antimicrobials and aggressive supportive care. Our aim was to study the effects of polymyxin-B direct hemoperfusion (PMX-DHP) therapy on sepsis-induced respiratory impairment, liver dysfunction and leucopenia in a neonatal cecal ligation and perforation (CLP) model.MethodsFourteen anesthetized and mechanically ventilated 3-day-old piglets underwent CLP and an arteriovenous extracorporeal circuit from 3 h until 6 h post-CLP, with a PMX column in the PMX-DHP treated group (7 piglets). Changes in oxygen saturation, PCO(2), base excess, white blood cell (WBC) count, platelet count, hematocrit (Hct%), serum glutamate pyruvate transaminase (SGPT), and serum glutamic oxaloacetic transaminase were measured before CLP and at 1, 3 and 6 h after.ResultsAt 6 h, the PMX-DHP group showed lower Hct%, and SGPT in comparison to the control group, but higher oxygen saturation and WBC count. No effects on the platelet count were found. The survival times of the PMX-DHP group were longer than in control.ConclusionPMX-DHP therapy limited the respiratory impairment, liver dysfunction and leucopenia in a neonatal septic model, which resulted in an improvement of survival time.

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