| Urinary liver-type fatty acid-binding protein in septic shock: effect of polymyxin B-immobilized fiber hemoperfusion. | |
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MedLine Citation:
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PMID: 18838948 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We aimed to determine retrospectively whether urinary liver-type fatty acid-binding protein (L-FABP) levels are altered in patients with septic shock or severe sepsis without shock and whether polymyxin B-immobilized fiber (PMX-F) hemoperfusion affects these levels. Forty patients with septic shock, 20 patients with severe sepsis without shock, 20 acute renal failure (ARF) patients without septic shock (mean serum creatinine, 2.8 mg/dL), and 30 healthy volunteers were included in this study. Polymyxin B-immobilized fiber hemoperfusion was performed twice in 40 patients. In addition, 10 patients with septic shock without PMX-F treatment (conventional treatment) were also enrolled in this study. Their families did not choose PMX-F treatment. Thus, their informed consents to perform PMX-F treatment were not obtained. Septic shock or severe sepsis was defined by the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee. Patients with septic shock were eligible for inclusion in the study if they had a definable source of infection and/or positive blood cultures. Patients with cardiogenic or hemorrhagic shock were excluded from the study. The patients were not randomly allocated to receive PMX-F treatment. Urinary and serum L-FABP levels were measured by enzyme-linked immunosorbent assay method. Plasma endotoxin levels in patients with septic shock were significantly higher than those in patients with severe sepsis (P < 0.05), patients with ARF (P < 0.001), and healthy subjects (P < 0.001). Urinary L-FABP levels in patients with septic shock were significantly higher than those in patients with severe sepsis without shock (P < 0.001), patients with ARF (P < 0.001), and healthy subjects (P < 0.001), whereas serum L-FABP levels showed no significant differences between patients with septic shock, patients with severe sepsis, patients with ARF, and healthy subjects. Urinary L-FABP was not correlated with serum L-FABP. Twenty-eight patients with septic shock survived, and 12 patients died. Polymyxin B-immobilized fiber treatment reduced plasma endotoxin levels (P < 0.01) and urinary L-FABP levels (P < 0.01). In 10 patients with septic shock without PMX-F treatment, L-FABP levels remained high 7 days after initiation of conventional treatment (P = 0.12). These results suggest that urinary L-FABP levels are significantly increased in patients with septic shock and that PMX-F treatment is effective in reducing these levels. |
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Authors:
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Tsukasa Nakamura; Takeshi Sugaya; Hikaru Koide |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Shock (Augusta, Ga.) Volume: 31 ISSN: 1540-0514 ISO Abbreviation: Shock Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-14 Completed Date: 2009-06-29 Revised Date: 2009-08-02 |
Medline Journal Info:
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Nlm Unique ID: 9421564 Medline TA: Shock Country: United States |
Other Details:
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Languages: eng Pagination: 454-9 Citation Subset: IM |
Affiliation:
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Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anti-Bacterial Agents / administration & dosage, therapeutic use* Endotoxins / blood Enzyme-Linked Immunosorbent Assay Fatty Acid-Binding Proteins / blood*, urine* Female Hemodynamics Hemoperfusion* / methods Humans Male Middle Aged Polymyxin B / administration & dosage, therapeutic use* Retrospective Studies Sepsis / blood, urine Shock, Septic / blood, drug therapy*, urine |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Endotoxins; 0/Fatty Acid-Binding Proteins; 1404-26-8/Polymyxin B |
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