• Toshinori Totsugawa, Masahiko Kuinose, Hidenori Yoshitaka, Yoshimasa Tsushima, Atsuhisa Ishida, Genta Chikazawa, Keijiro Katayama, and Arudo Hiraoka.
• Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, 2-1-10 Marunouchi, Okayama 700-0823, Japan. toshinoritotsugawa@mac.com
• Gen Thorac Cardiovasc Surg. 2011 Feb 1; 59 (2): 98-104.

PurposeEndotoxin adsorption treatment (direct hemoperfusion using a polymyxin-B immobilized fiber column, or PMX-DHP) is now considered a useful option for treating severe sepsis. However, the efficacy of PMX-DHP for infective endocarditis (IE), in which the causative microorganisms are usually gram-positive cocci, remains unclear. In the present study, we investigated the impact of intraoperative PMX-DHP on clinical parameters during the treatment of IE.MethodsFrom November 2006 to December 2009, a total of 11 patients with active IE underwent emergent surgery using intraoperative PMX-DHP. The perioperative courses of these patients were compared with those of seven patients who underwent emergent surgery for active IE with the conventional method from January 2003 to October 2006.ResultsPMX-DHP was associated with a significant decrease in the postoperative catecholamine dose and duration. Intubation time and intensive care unit length of stay for the PMX-DHP group was significantly shorter than that for the conventional therapy group. There was also a significant difference in the number of failed organs postoperatively between the two groups.ConclusionIntraoperative PMX-DHP demonstrated several positive effects, such as a drastic decrease in the doses of inotropic agents and shortening of the duration of mechanical ventilation, in patients who underwent emergent surgery for active IE. Intraoperative PMX-DHP can be a useful option for the treatment of critically ill patients with IE.© The Japanese Association for Thoracic Surgery 2011

39 keywords...

hide…