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Treatment with polymyxin B-immobilized fiber reduces platelet activation in septic shock patients: decrease in plasma
T Nakamura1, I Ebihara, H Shoji
1Department of Medicine, Misato Junshin Hospital, Saitama, Japan.
Objective:
To clarify whether plasma concentrations of soluble P-selectin, platelet factor-4 (PF-4) and beta-thromboglobulin (betaTG) are altered in patients with septic shock and whether polymyxin B-immobilized fiber (PMX-F) treatment affects these changes.
Subjects:
Thirty patients with septic shock who were treated with PMX-F (group A), 20 such patients who received conventional therapies (group B) and 20 healthy control subjects(group C).
Methods:
ELISA using commercial kits. Endotoxin elimination by direct hemoperfusion using PMX-F.
Results:
Blood endotoxin levels decreased significantly from 49.4+/-8.8 pg/ml to 13.0+/-4.5 pg/ml after PMX-F treatment. The pretreatment plasma concentrations of soluble P-selectin, PF-4 and betaTG in patients in groups A and B were significantly higher than those in group C (p<0.001). Plasma concentrations of these factors decreased significantly in group A after PMX-F treatment (p<0.01); however, the concentrations in group B were not altered after conventional treatment. The survival rate of group A (60%) was higher than that of group B (30%).
Conclusions:
Our findings suggest that soluble P-selectin, PF-4 and betaTG may be associated with septic shock and that PMX-F is effective in reducing these markers in patients with septic shock.