Document Detail


Early management of endotoxemia using the endotoxin activity assay and polymyxin B-based hemoperfusion.
MedLine Citation:
PMID:  20519903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We evaluated the ability of the endotoxin activity (EA) assay to determine the need for early intervention for endotoxemia using polymyxin B-based hemoperfusion (PMX-DHP) on septic patients. METHODS: Twenty-four patients were enrolled. Eleven patients had a high EA level (> or = 0.6) and were treated with PMX-DHP every 24 h until the EA level was low ( < 0.4). The remaining 13 patients had EA levels < 0.60 and received standard therapy only. RESULTS: Two PMX-DHP treatments were performed on 4 patients, three treatments on 6 patients and four treatments on 1 patient. After the therapy, mean arterial pressure increased (69.45 to 84.09 mm Hg; p < 0.01), heart rate decreased (Ill.73 to77.91 beats/min; p < 0.01), white blood cell count decreased (18,380 to 9,550 cells/mm(3); p < 0.01), the PMN (polymorphonuclear) percentage decreased (88.45 to 67.82%; p < 0.01) and PaO(2)/FiO(2) increased (275 to 308.09; p < 0.01). All 24 patients survived to the 28-day follow-up. CONCLUSION: The EA assay can identify patients eligible for PMX-DHP treatment and aids its therapeutic dosing.
Authors:
G Novelli; G Ferretti; F Ruberto; V Morabito; F Pugliese
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Publication Detail:
Type:  Journal Article     Date:  2010-06-01
Journal Detail:
Title:  Contributions to nephrology     Volume:  167     ISSN:  1662-2782     ISO Abbreviation:  Contrib Nephrol     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-03     Completed Date:  2010-07-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513582     Medline TA:  Contrib Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  91-101     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Dipartimento P. Stefanini Chirurgia Generale e Trapianti d'Organo, IT-00161 Rome, Italy. novelligilnardo@virgilio.it
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MeSH Terms
Descriptor/Qualifier:
Apnea / etiology
Bacterial Infections / drug therapy,  epidemiology
Blood Pressure / drug effects
Carbon Dioxide / blood
Combined Modality Therapy
Endotoxemia / blood,  drug therapy*
Endotoxins / blood*,  isolation & purification
Female
Fever / etiology
Genital Neoplasms, Female / surgery
Gram-Negative Bacterial Infections / drug therapy,  etiology
Heart Rate / drug effects
Hemoperfusion / methods*
Humans
Hypothermia / etiology
Kidney Transplantation / adverse effects
Liver Transplantation / adverse effects
Lung Transplantation / adverse effects
Polymyxin B / therapeutic use*
Postoperative Complications / blood*,  drug therapy
Survivors
Chemical
Reg. No./Substance:
0/Endotoxins; 124-38-9/Carbon Dioxide; 1404-26-8/Polymyxin B

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


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