Document Detail

Direct hemoperfusion with polymyxin B immobilized fiber for abdominal sepsis in Europe.
MedLine Citation:
PMID:  21626318     Owner:  NLM     Status:  MEDLINE    
Since direct hemoperfusion with polymyxin B immobilized fiber (PMX-DHP) received its product certification for use in Europe in 1998, several prospective randomized controlled trials (RCTs) have been conducted in European countries. The first RCT, performed in six European academic medical centers in 2005, concluded that PMX-DHP is associated with improved hemodynamic status and cardiac function. Subsequently, a meta-analysis of PMX-DHP was presented in Italy in 2007. This systematic review found positive effects of PMX-DHP on mean arterial pressure and dopamine/ dobutamine use, PaO2/FiO2 ratio, endotoxin removal, and mortality. However, like most trials on extracorporeal therapies, none of the studies was double-blinded. The EUPHAS study, a multicenter RCT performed in ten Italian intensive care units in 2009, found that PMX-DHP improved 28-day survival, blood pressure, vasopressor requirement, and degree of organ failure. However, investigators in Belgium and Canada pointed out that there was no statistical difference in 28-day survival. Two more RCTs, the ABDO-MIX and EUPHRATES studies, the primary end points of which are 28-day mortality, were started in Europe and the United States at the end of 2010. We are hoping that these RCTs will resolve this issue.
Koichi Sato; Hiroshi Maekawa; Mutsumi Sakurada; Hajime Orita; Yoshihiro Komatsu
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Surgery today     Volume:  41     ISSN:  1436-2813     ISO Abbreviation:  Surg. Today     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-31     Completed Date:  2011-09-27     Revised Date:  2011-10-27    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  754-60     Citation Subset:  IM    
Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, 1129 Izunokuni, Shizuoka, 410-2295, Japan.
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MeSH Terms
Anti-Bacterial Agents / administration & dosage*
Endotoxins / blood
Meta-Analysis as Topic
Polymyxin B / administration & dosage*
Randomized Controlled Trials as Topic
Sepsis / blood,  drug therapy*
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Endotoxins; 1404-26-8/Polymyxin B

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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