Open AccessEffect of Direct Hemoperfusion With a Polymyxin B Immobilized Fiber Column on High Mobility Group Box-1 (HMGB-1) in Severe Septic Shock: Report of a Case
Author(s) -
Yuichiro Sakamoto,
Kunihiro Mashiko,
Hisashi Matsumoto,
Yoshiaki Hara,
Noriyoshi Kutsukata,
Kenkichi Takei,
Yuta Ueno,
Yoshiteru Tomita,
Yasuhiro Yamamoto
Publication year - 2006
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/01.mat.0000248996.22865.ce
Subject(s) - hemoperfusion , polymyxin b , septic shock , polymyxin , chemistry , medicine , fiber , microbiology and biotechnology , chromatography , surgery , antibiotics , sepsis , biology , biochemistry , organic chemistry , hemodialysis
Because of the many difficult aspects in the treatment of septic shock and poor outcome of this condition, establishing the most appropriate therapeutic strategy is problematic. Recently, high mobility group box-1 (HMGB-1) has been shown to activate inflammatory responses and to be a late mediator in endotoxemia and sepsis. Therefore, we considered that it might be worthwhile to investigate the therapeutic potential of HMGB-1 blockade in cases of septic shock.Herein, we describe the case of a patient with septic shock with hepatic portal venous gas caused by intestinal obstruction. Hepatic portal venous gas is a rare condition associated with significant radiographic findings and a fatal outcome. Our patient, however, recovered from severe septic shock and was saved by the use of direct hemoperfusion with a polymyxin B immobilized fiber column (DHP-PMX). This treatment resulted in a decrease in the serum levels of endotoxin, interleukin-6 (IL-6), and HMGB-1.