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Clinical effects of polymyxin B-immobilized fiber column in septic patients

Dinna N Cruz1, Rinaldo Bellomo, Claudio Ronco

  • 1Department of Nephrology, Ospedale San Bortolo, Vicenza, Italy. dinnacruzmd@yahoo.com

Contributions to Nephrology
|April 28, 2007
PubMed

Insights

Polymyxin-B-immobilized fiber (PMX-F) hemoperfusion shows promise for treating gram-negative septic shock by lowering endotoxin levels. This extracorporeal therapy may reduce mortality, but larger trials are needed for confirmation.

Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Immunology

Background:

  • Gram-negative septic shock is primarily caused by endotoxins.
  • Previous antiendotoxin and anticytokine therapies have shown limited clinical success.
  • Extracorporeal therapies are being explored to reduce sepsis mediators.

Purpose of the Study:

  • To evaluate the efficacy of direct hemoperfusion with polymyxin-B-immobilized fiber (PMX-F) in treating gram-negative sepsis.
  • To assess the impact of PMX-F therapy on endotoxin levels, blood pressure, and mortality.

Main Methods:

  • A systematic review of 28 studies involving 1,390 patients was conducted.
  • The review analyzed preliminary results of PMX-F therapy in critically ill patients.

Main Results:

  • PMX-F therapy demonstrated a significant reduction in circulating endotoxin levels.
  • Improvements in blood pressure and a decrease in mortality were observed.
  • Publication bias and lack of blinding were noted as limitations.

Conclusions:

  • PMX-F hemoperfusion is a potentially effective treatment for gram-negative sepsis.
  • Further large-scale, controlled clinical trials are necessary to validate these findings.

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