| Early management of endotoxemia using the endotoxin activity assay and polymyxin B-based hemoperfusion. | |
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MedLine Citation:
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PMID: 20519903 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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G Novelli; G Ferretti; F Ruberto; V Morabito; F Pugliese |
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Publication Detail:
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Type: Journal Article Date: 2010-06-01 |
Journal Detail:
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Title: Contributions to nephrology Volume: 167 ISSN: 1662-2782 ISO Abbreviation: Contrib Nephrol Publication Date: 2010 |
Date Detail:
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Created Date: 2010-06-03 Completed Date: 2010-07-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7513582 Medline TA: Contrib Nephrol Country: Switzerland |
Other Details:
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Languages: eng Pagination: 91-101 Citation Subset: IM |
Copyright Information:
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Copyright 2010 S. Karger AG, Basel. |
Affiliation:
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Dipartimento P. Stefanini Chirurgia Generale e Trapianti d'Organo, IT-00161 Rome, Italy. novelligilnardo@virgilio.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Apnea
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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:
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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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