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Published on: January 31, 2018
[The effect of operating time of PMX-DHP on decrease of platelets]
Kazushige Ooishi1, Takashi Etou, Satoko Koga
1Department of Anesthesiology and Intensive Care Medicine, Beppu Medical Center, Ooita 874-0011.
Background:
Recently, it is said that long-term PMX-DHP is beneficial for severe septic shock. Decrease in platelets, however, is one of the problems of PMX-DHP. We retrospectively examined the effect of operating time of PMX-DHP on decrease of platelets.
Methods:
Forty-nine subjects were divided into three subgroups by their operating times of PMX-DHP. In short (S) group, the operating time was below 4 hours, and the group comsisted of 13 subjects. Intermediate (I) group with operating time of 4-12 hours, had 15 subjects. And long (L) group with operating time of 12-24 hours, had 21 subjects. Rate of decrease of platelets was compared between these subgroups.
Results:
Decreased rate of platelets of each sub-group is as follows; S group showed 16.7 +/- 28.4%, I group showed 25.5 +/- 28.1%, and L group showed 23.7 +/- 30.3% respectively. And there were no significant differences between these subgroups.
Conclusions:
Decreased rate of platelets was around 20% as previously reported and constant regardless of duration of operating times of PMX-DHP. Long-term PMX-DHP within 24 hours is practically safe in case of severe septic shock.
Insights
Long-term use of polymyxin B-hemoperfusion (PMX-DHP) appears safe for severe septic shock, as platelet decrease remains consistent regardless of treatment duration. This finding supports PMX-DHP
Area of Science:
- Critical Care Medicine
- Nephrology
- Immunology
Background:
- Long-term polymyxin B-hemoperfusion (PMX-DHP) is increasingly recognized for its benefits in severe septic shock.
- A known complication of PMX-DHP is a decrease in platelet count, necessitating further investigation into its relationship with treatment duration.
Purpose of the Study:
- To investigate the impact of PMX-DHP operating time on the reduction of platelet counts in patients with severe septic shock.
Main Methods:
- A retrospective analysis was conducted on 49 patients with severe septic shock undergoing PMX-DHP.
- Patients were categorized into three groups based on PMX-DHP operating time: Short (S, <4 hours), Intermediate (I, 4-12 hours), and Long (L, 12-24 hours).
- The rate of platelet decrease was compared across these subgroups.
Main Results:
- The mean platelet decrease rates were 16.7% (S group), 25.5% (I group), and 23.7% (L group).
- No statistically significant differences in platelet decrease rates were observed between the short, intermediate, and long operating time groups.
Conclusions:
- Platelet reduction during PMX-DHP was approximately 20%, consistent with previous reports and independent of treatment duration.
- PMX-DHP, even with extended use up to 24 hours, is considered practically safe concerning platelet levels in severe septic shock management.
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