Early initiation of polymyxin B-immobilized fiber therapy effective for septic shock after aortic replacement.

Abstract

A 76-year-old female underwent ascending aorta and partial arch replacement. She developed septic shock on postoperative day 6. She was administered dopamine, 10 microg x kg(-1) x min(-1); dobutamine, 5 microg x kg(-1) x min(-1); and norepinephrine, 0.3 microg x kg(-1) x min(-1). However, the blood pressure was 74/40 mmHg. Direct hemoperfusion using polymyxin B-immobilized fiber (PMX-DHP) was started; 3 h later, the blood pressure increased to 118/54 mmHg. Norepinephrine was stopped, and dopamine and dobutamine doses were decreased to 5 microg x kg(-1) x min(-1) 3 and 12 h after completing PMX-DHP, respectively. In suspected septic shock, early PMX-DHP simultaneously with drug treatment facilitates hemodynamic improvement.

• Authors: Masanori Murakami, Yoshitoyo Miyauchi, Masahiko Nishida, Haruhiko Okada, Kimikazu Hamano
• Journal: Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia (Ann Thorac Cardiovasc Surg) Vol. 13 Issue 4 Pg. 287-9 (Aug 2007) ISSN: 1341-1098 [Print] Japan
• PMID: 17717510 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Polymyxin B

Topics

• Aged
• Anti-Bacterial Agents (therapeutic use)
• Aortic Aneurysm (surgery)
• Blood Vessel Prosthesis Implantation
• Brachiocephalic Trunk (surgery)
• Female
• Humans
• Polymyxin B (therapeutic use)
• Postoperative Complications
• Shock, Septic (drug therapy, etiology)