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Therapeutic Apheresis for Septic Patients with Organ Dysfunction: Hemoperfusion using a Polymyxin B Immobilized Column
Author(s) -
Tani Tohru,
Hanasawa Kazuyoshi,
Endo Yoshihiro,
Yoshioka Toyokazu,
Kodama Masashi,
Kaneko Masamitsu,
Uchiyama Yoshimitsu,
Akizawa Tadao,
Takahasi Kodo,
Sugai Katsuo
Publication year - 1998
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.1998.06086.x
Subject(s) - hemoperfusion , polymyxin b , polymyxin , apheresis , medicine , intensive care medicine , microbiology and biotechnology , antibiotics , surgery , hemodialysis , biology , platelet
A prospective clinical study was performed to evaluate a new method of treatment of endotoxin shock, a column containing polystyrene fibers with covalently bound immobile polymyxin B. Direct hemoperfusion using the column removes circulating endotoxin by adsorption. All of the patients studied, 37 in the treatment group and 33 in the control group, had endotoxemia and failure of 1 or more organs. The perfusion was performed 1–7 times per patient, 2 h/session. The survival rate was significantly higher in the treatment group (54%) than in the controls (36.4%). The mean plasma endotoxin concentration was significantly lowered by the treatment from 83.7 pg/ml before perfusion to 56.4 pg/ml immediately after and 28.5 pg/ml the day after the treatment, and the posttreatment level was much lower in those who survived (mean, 18.8 pg/ml) compared to those who died (mean, 88 pg/ml). Various parameters of cardiac function also improved after the treatment.