| Abstract | BACKGROUND: Direct hemoperfusion with the polymyxin B-immobilized fiber (PMX-20R) column has a positive effect on outcome in patients with sepsis or septic shock. The PMX-05R column has a low priming volume and has been used in pediatric patients with septic shock. The aim of the present study was to determine whether PMX-F treatment with the PMX-05R column is effective in elderly patients with septic shock. PATIENTS AND METHODS: We performed direct hemoperfusion twice with the PMX-05R column in 8 septic shock patients who were over 80 years of age. Five of the 8 patients survived. The 3 patients who died were undergoing hemodialysis for chronic renal failure, and methicillin-resistant Staphylococcus aureus was detected in all 3. RESULTS: PMX-F treatment significantly increased systolic and diastolic blood pressures (P = 0.0004 for both) and significantly reduced heart rate (P < 0.0001), the blood endotoxin level (P = 0.0011), blood IL-6 level (P = 0.039), C-reactive protein level (P < 0.0001), and white blood cell count (P < 0.0001). CONCLUSIONS: Direct hemoperfusion with the PMX-05R column is effective in ameliorating clinical and laboratory abnormalities in elderly septic shock patients. |
| Authors | Tsukasa Nakamura, Yasuhiro Kawagoe, Tsukasa Suzuki, Hisataka Shoji, Yoshihiko Ueda, Hikaru Koide
(Affiliation: Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.)
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| Journal | The American journal of the medical sciences
(Am J Med Sci)
Vol. 334
Issue 4
Pg. 244-7
(Oct 2007)
ISSN: 0002-9629 United States |
| PMID | 18030179
(Publication Type: Clinical Trial, Journal Article)
|
| Chemical References |
- Anti-Bacterial Agents
- Endotoxins
- Interleukin-6
- Polymyxin B
- C-Reactive Protein
|
| Topics |
- Age Factors
- Aged, 80 and over
- Anti-Bacterial Agents
(adverse effects, pharmacology, therapeutic use)
- Blood Pressure
(drug effects)
- C-Reactive Protein
(metabolism)
- Dose-Response Relationship, Drug
- Endotoxins
(blood)
- Female
- Heart Rate
(drug effects)
- Hemoperfusion
(instrumentation, methods)
- Humans
- Interleukin-6
(blood)
- Male
- Polymyxin B
(adverse effects, pharmacology, therapeutic use)
- Shock, Septic
(drug therapy, metabolism, physiopathology)
- Survival Analysis
- Treatment Outcome
|
