Newly developed immobilized polymyxin B fibers improve the survival of patients with sepsis.

Abstract

BACKGROUND:

Sepsis and septic shock are still major causes of morbidity and mortality in spite of the availability of powerful and broadly active antibiotics.

METHODS:

A prospective, open and randomized trial of the effect of immobilized polymyxin fibers (PMX-F) on the survival of patients with sepsis throughout a follow-up period of 28 days or until discharge, if earlier, was carried out. Ninety-eight patients were included who met at least 4 of the criteria for systemic inflammatory response syndrome due to infection. The patients were classified into three groups based on their Acute Physiology and Chronic Health Evaluation (APACHE) II score.

RESULTS:

The overall survival rate was significantly improved by using PMX-F compared to the control group (41 vs. 11%) (p = 0.002). In patients with an APACHE II score less than 20, treatment with PMX-F was shown to improve outcome (65 vs. 19%) (p = 0.01). In cases of more severe sepsis with an APACHE II score of 20-29, PMX-F still maintained efficacy in improving outcome (40 vs. 11%) (p = 0.04). However, PMX-F treatment did not improve the survival rate in patients with an APACHE II score of greater than 30 (survival rate 7 vs. 0%) (p = 0.59).

CONCLUSION:

From these results, it is concluded that treatment with PMX-F in patients with sepsis is effective and prolongs the survival rate when applied at an early stage of sepsis. However, in severe sepsis, this therapy does not improve the survival rate.

• Authors: H Nemoto, H Nakamoto, H Okada, S Sugahara, K Moriwaki, M Arai, Y Kanno, H Suzuki
• Journal: Blood purification (Blood Purif) Vol. 19 Issue 4 Pg. 361-8; discussion 368-9 ( 2001) ISSN: 0253-5068 [Print] Switzerland
• PMID: 11574732 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright 2001 S. Karger AG, Basel

Chemical References

• Endotoxins
• Polymyxin B

Topics

• APACHE
• Aged
• Endotoxins (blood)
• Female
• Gram-Negative Bacteria (chemistry, classification)
• Hemoperfusion
• Humans
• Male
• Middle Aged
• Polymyxin B (therapeutic use)
• Prospective Studies
• Survival Analysis
• Survival Rate
• Systemic Inflammatory Response Syndrome (mortality, therapy)
• Treatment Outcome