A PILOT-CONTROLLED STUDY OF A POLYMYXIN B-IMMOBILIZED HEMOPERFUSION CARTRIDGE IN PATIENTS WITH SEVERE SEPSIS SECONDARY TO INTRA-ABDOMINAL INFECTION
Autor: | Stephanie John, Pierre-François Laterre, Dolores Marzo, Xavier Wittebole, Daniel De Backer, Haruji Nakamura, Hajo A. Bruining, Jonathan Cohen, Stephen J. Brett, Jean Louis Vincent, Francisco Alvarez Lerma, Hilmar Burchardi |
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Rok vydání: | 2005 |
Předmět: |
Adult
Male Time Factors medicine.medical_treatment Cardiac index Pilot Projects Kidney Critical Care and Intensive Care Medicine law.invention Sepsis law Intensive care medicine Humans Renal replacement therapy Aged Polymyxin B Interleukin-6 business.industry Septic shock Myocardium Organ dysfunction Middle Aged medicine.disease Hemoperfusion Shock Septic Intensive care unit Anti-Bacterial Agents Endotoxins Perfusion Treatment Outcome Anesthesia Emergency Medicine Female medicine.symptom business |
Zdroj: | Shock. 23:400-405 |
ISSN: | 1073-2322 |
Popis: | Endotoxin is an important pathogenic trigger for sepsis. The polymyxin B-immobilized endotoxin removal hemoperfusion cartridge, Toraymyxin (hereafter PMX), has been shown to remove endotoxin in preclinical and open-label clinical studies. In a multicenter, open-label, pilot, randomized, controlled study conducted in the intensive care unit in six academic medical centers in Europe, 36 postsurgical patients with severe sepsis or septic shock secondary to intra-abdominal infection were randomized to PMX treatment of 2 h (n = 17) or standard therapy (n = 19). PIVIX was well tolerated and showed no significant side effects. There were no statistically significant differences in the change in endotoxin levels from baseline to 6 to 8 h after treatment or to 24 h after treatment between the two groups. There was also no significant difference in the change in interleukin (IL)-6 levels from baseline to 6 to 8 h after treatment or to 24 h after treatment between the two groups. Patients treated with PMX demonstrated significant increases in cardiac index (CI; P = 0.012 and 0.032 at days 1 and 2, respectively), left ventricular stroke work index (LVSWI, P = 0.015 at day 2), and oxygen delivery index (DO2I, P = 0.007 at day 2) compared with the controls. The need for continuous renal replacement therapy (CRRT) after study entry was reduced in the PIVIX group (P = 0.043). There was no significant difference between the groups in organ dysfunction as assessed by the Sequential Organ Failure Assessment (SOFA) scores from day 0 (baseline) to day 6. Treatment using the PIVIX cartridge is safe and may improve cardiac and renal dysfunction due to sepsis or septic shock. Further studies are needed to prove this effectiveness. |
Databáze: | OpenAIRE |
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