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Background  Direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) has been widely used for patients with septic shock around the world, but the prognostic factors have not been fully understood. We conducted a retrospective analysis to determine the prognostic factors in patients with septic shock who underwent PMX-DHP.    Methods  Twenty-nine patients with septic shock who underwent PMX-DHP were included in the study. The patients were divided into groups based on survival ( n  = 23) and non-survival ( n  = 6) 28 days after PMX-DHP, and the clinical data for the two groups before and after PMX-DHP were compared.    Results  In non-survivors, the vasopressor dependency index before PMX-DHP was significantly higher ( p  = 0.046), and the leukocyte count before PMX-DHP was significantly lower ( p  = 0.024) than in survivors. Furthermore, base excess after PMX-DHP was significantly lower in non-survivors ( p  = 0.007) than in survivors. The optimal cutoff points of the vasopressor dependency index, leukocyte count, and base excess identified by receiver operating characteristic curves were 0.499/mmHg, 1360/μL, and −6.4 mmol/L, respectively. And the score using these three cutoffs, termed the prognostic score, was related to the prognosis of septic shock patients who underwent PMX-DHP (area under the curve = 0.946).    Conclusions  The prognostic score, using three parameters which are immediately and readily available in early phase after starting PMX-DHP, might be useful to predict the prognosis of these patients.

journal of intensive care

Prognostic factors in patients with septic shock in digestive surgery who have undergone direct hemoperfusion with polymyxin B-immobilized fibers: a retrospective observational study