Document Detail


Polymyxin B-immobilized fiber hemoperfusion with the PMX-05R column in elderly patients suffering from septic shock.
MedLine Citation:
PMID:  18030179     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Direct hemoperfusion with the polymyxin B-immobilized fiber (PMX-20R) column has a positive effect on outcome in patients with sepsis or septic shock. The PMX-05R column has a low priming volume and has been used in pediatric patients with septic shock. The aim of the present study was to determine whether PMX-F treatment with the PMX-05R column is effective in elderly patients with septic shock. PATIENTS AND METHODS: We performed direct hemoperfusion twice with the PMX-05R column in 8 septic shock patients who were over 80 years of age. Five of the 8 patients survived. The 3 patients who died were undergoing hemodialysis for chronic renal failure, and methicillin-resistant Staphylococcus aureus was detected in all 3. RESULTS: PMX-F treatment significantly increased systolic and diastolic blood pressures (P = 0.0004 for both) and significantly reduced heart rate (P < 0.0001), the blood endotoxin level (P = 0.0011), blood IL-6 level (P = 0.039), C-reactive protein level (P < 0.0001), and white blood cell count (P < 0.0001). CONCLUSIONS: Direct hemoperfusion with the PMX-05R column is effective in ameliorating clinical and laboratory abnormalities in elderly septic shock patients.
Authors:
Tsukasa Nakamura; Yasuhiro Kawagoe; Tsukasa Suzuki; Hisataka Shoji; Yoshihiko Ueda; Hikaru Koide
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  334     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-11-21     Completed Date:  2007-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  244-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged, 80 and over
Anti-Bacterial Agents / adverse effects,  pharmacology,  therapeutic use*
Blood Pressure / drug effects
C-Reactive Protein / metabolism
Dose-Response Relationship, Drug
Endotoxins / blood
Female
Heart Rate / drug effects
Hemoperfusion / instrumentation*,  methods
Humans
Interleukin-6 / blood
Male
Polymyxin B / adverse effects,  pharmacology,  therapeutic use*
Shock, Septic / drug therapy*,  metabolism,  physiopathology
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Endotoxins; 0/Interleukin-6; 1404-26-8/Polymyxin B; 9007-41-4/C-Reactive Protein

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


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