| Effects of PMX-DHP treatment for patients with directly induced acute respiratory distress syndrome. | |
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MedLine Citation:
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PMID: 17381535 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Endotoxin-removal direct hemoperfusion column containing polymyxin B immobilized fibers (PMX-DHP) is an effective procedure for the treatment of sepsis-induced acute respiratory distress syndrome (ARDS). We investigated retrospectively the effects and appropriate timing of PMX-DHP induction for directly induced ARDS in 38 patients. PMX-DHP was carried out twice for two hours. Blood pressure, heart rate (HR) and PaO(2)/FIO(2) (PF) ratio, leukocytes, platelets, endotoxin, inflammatory cytokines and clusters of differentiated peripheral neutrophils and monocytes were measured before and after PMX-DHP. Acute Physiology and Chronic Health Evaluation (APACHE) II scores, Sequential Organ Failure Assessment (SOFA) scores and lung injury scores (LIS) were determined at the time of starting PMX-DHP. The underlying causes of ARDS were pneumonia in 29 patients and aspiration pneumonia in 9 patients. The patients were divided into Survivors (n = 21) and Nonsurvivors (n = 17). Mortality was 45% at 30 days after PMX-DHP. The APACHE II and SOFA scores and the LIS were not significantly different between the two groups. The time from the onset of ARDS to the start of PMX-DHP was significantly delayed between the two groups. PMX-DHP significantly improved the PF ratio, HR and systolic blood pressure in the Survivors compared to the Nonsurvivors. The function of active monocytes in the peripheral blood was significantly suppressed after PMX-DHP. This early induction of PMX-DHP is indicated for directly induced ARDS. In the Nonsurvivors, this delay could have led to undesirable responses to oxygenation and circulation after PMX-DHP. |
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Authors:
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Kenji Tsushima; Keishi Kubo; Sumiko Yoshikawa; Tomonobu Koizumi; Masanori Yasuo; Shino Furuya; Kazuhiko Hora |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy Volume: 11 ISSN: 1744-9979 ISO Abbreviation: Ther Apher Dial Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-03-26 Completed Date: 2007-11-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101181252 Medline TA: Ther Apher Dial Country: Australia |
Other Details:
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Languages: eng Pagination: 138-45 Citation Subset: IM |
Affiliation:
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First Department of Internal Medicine, Shinshu University School of Medicine, Asahi, Matsumoto, Japan. tsushima@hsp.md.shinshu-u.ac.jp |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Aged Anti-Bacterial Agents / therapeutic use* Chromatography Endotoxins / blood Female Hemoperfusion / methods* Humans Male Multiple Organ Failure Polymyxin B / therapeutic use* Respiratory Distress Syndrome, Adult / mortality, therapy* Retrospective Studies Sepsis / therapy* Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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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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