• Tomoharu Shimizu, Kazuyoshi Hanasawa, Tohru Tani, Yoshihiro Endo, Yoshimasa Kurumi, Toshiaki Ikeda, Naohiro Fujita, Hiroyuki Morita, Hitoshi Imaizumi, Takashi Sato, and Hiroshi Katayama.
• PMX Hemodynamics Study Group, Shiga University of Medical Science, Shiga, Japan.
• Blood Purif. 2003 Jan 1; 21 (3): 237-43.

Background/AimsThis study evaluated the mechanism of hemodynamic improvement in polymyxin B-immobilized fiber (PMX) treatment.MethodsFifteen septic patients with endotoxemia and/or gram negative infection were treated with PMX. Plasma concentrations of calcitonin gene-related peptide (CGRP) and nitric oxide metabolites were measured.ResultsCGRP and nitric oxide metabolites before treatment were significantly higher than in healthy controls. CGRP had a significantly inverse correlation with diastolic blood pressure and a positive correlation with the Septic Severity Score and the number of failed organs. Systolic and diastolic blood pressure and systemic vascular resistance index increased significantly both immediately after and 24 h after PMX treatment. CGRP decreased significantly 24 h after the treatment. In contrast, there were no significant changes in nitric oxide metabolites.ConclusionPMX treatment improved hemodynamic parameters in septic patients, and CGRP increased with increasing severity of sepsis. We conclude that a decrease in CGRP levels may be related to hemodynamic improvement resulting from PMX treatments.Copyright 2003 S. Karger AG, Basel

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