Polymyxin B-immobilized fiber column direct hemoperfusion and continuous hemodiafiltration in premature neonates with systemic inflammatory response syndrome
Autor: | Hisanori Minakami, Yoshinobu Maede, Daijiro Takahashi, Takuya Tokuhisa, Seiro Machigashira, Satoshi Ibara, Takako Matsui, Chie Ishihara, Eiji Hirakawa |
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Rok vydání: | 2016 |
Předmět: |
Male
medicine.medical_specialty medicine.drug_class medicine.medical_treatment Polymyxin Hemodiafiltration Infant Premature Diseases 030204 cardiovascular system & hematology Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Infant Very Low Birth Weight Adverse effect Polymyxin B Retrospective Studies Interleukin-6 business.industry Tracheal intubation Infant Newborn 030208 emergency & critical care medicine medicine.disease Hemoperfusion Systemic Inflammatory Response Syndrome Surgery Oxygen tension Systemic inflammatory response syndrome Treatment Outcome Bronchopulmonary dysplasia Pediatrics Perinatology and Child Health Gestation Female business Infant Premature Follow-Up Studies |
Zdroj: | Pediatrics International. 58:1176-1182 |
ISSN: | 1328-8067 |
DOI: | 10.1111/ped.13006 |
Popis: | Background There have been no previous studies regarding whether combined use of Polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) and continuous hemodiafiltration (CHDF) is helpful in the treatment of preterm infants with systemic inflammatory response syndrome (SIRS) and hypercytokinemia. Methods A retrospective review was carried out of 18 SIRS infants born at gestational week 24–28. Eight with blood interleukin (IL)-6 ≥ 1000 pg/mL were treated actively with 2 h PMX-DHP followed by 2 h PMX-DHP and CHDF. Ten with IL-6 < 500 pg/mL were treated conventionally (with neither PMX-DHP nor CHDF) and served as controls. Results Demographic characteristics were similar except for IL-6, arterial-to-alveolar oxygen tension ratio (a/APO2), and number of immature neutrophils between the two groups. Baseline a/APO2 was significantly lower in infants with than without active treatment (0.44 vs 0.67, respectively, P = 0.002). After 4 h treatment, the IL-6 decreased to < 500 pg/mL in all eight infants, and a/APO2 improved significantly to 0.62 (P = 0.006). Bronchopulmonary dysplasia occurred in a similar proportion (63%, 5/8 vs 80%, 8/10, respectively), but the number of days on inhaled oxygen (30 vs 47 days, respectively, P = 0.033) and tracheal intubation (36 vs 51 days, respectively, P = 0.040) was significantly lower in infants with than without active treatment. Prevalence of adverse events was similar (13%, 1/8 vs 50%, 5/10 for active vs conventional treatment, respectively). Conclusion Active treatment with PMX-DHP and CHDF was helpful in the reduction of days on inhaled oxygen and tracheal intubation in preterm SIRS infants with hypercytokinemia. Further prospective randomized studies are warranted. |
Databáze: | OpenAIRE |
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