Document Detail


Hemoperfusion with a polymyxin B fiber column decreases clotting activity.
MedLine Citation:
PMID:  19954477     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated whether hemoperfusion with a polymyxin B column (DHP-PMX) was able to improve coagulation abnormalities in patients with sepsis. Sixteen patients with sepsis were enrolled in the study. They all had signs of systemic inflammatory response syndrome due to infection and a mean arterial blood pressure > or =65mm Hg (irrespective of the use of catecholamines). A thermodilution catheter was inserted prior to DHP-PMX for intravenous infusion, and DHP-PMX was performed twice within 24 h for 3 h each time. Circulating levels of thrombin-antithrombin complex (TAT), plasmin-alpha2 plasmin inhibitor complex (PIC), the TAT/PIC ratio, and plasminogen activator inhibitor-1 (PAI-1) were measured six times. Before DHP-PMX, the TAT level was 24.5 +/- 8.3 ng/mL, the PIC level was 2.5 +/- 1.1 microg/mL, the TAT/PIC ratio was 13.9 +/- 3.5, and the PAI-1 level was 143.0 +/- 24.4 ng/L. The TAT level, TAT/PIC ratio, and PAI-1 were all significantly lower (P < 0.05) after 48 hr compared with before DHP-PMX, but no significant change of PIC was observed. In these patients with sepsis, fibrinolysis was inhibited by PAI-1, whereas clotting activity was significantly increased. This coagulation/fibrinolysis imbalance was improved by DHP-PMX. The present results suggest that indirect inhibition of clotting activity can be achieved in patients with sepsis through adsorption of lipopolysaccharide by DHP-PMX.
Authors:
Hidehiko Kushi; Takahiro Miki; Yuichiro Sakagami; Jun Sato; Takeshi Saito; Katsuhisa Tanjoh
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
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:  13     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-03     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  528-33     Citation Subset:  IM    
Affiliation:
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Surugadai, Chiyoda-ku, Tokyo 101-8306, Japan. hkushi@med.nihon-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adsorption
Adult
Aged
Aged, 80 and over
Blood Coagulation*
Blood Coagulation Tests / methods
Blood Pressure
Female
Fibrinolysis
Hemoperfusion / methods*
Humans
Lipopolysaccharides / metabolism
Male
Middle Aged
Plasminogen Activator Inhibitor 1 / blood
Polymyxin B / chemistry*
Prospective Studies
Sepsis / therapy*
Thermodilution / methods
Chemical
Reg. No./Substance:
0/Lipopolysaccharides; 0/Plasminogen Activator Inhibitor 1; 1404-26-8/Polymyxin B

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


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