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Effect of hemoperfusion using polymyxin B-immobilized fibers on non-shock rat sepsis model
Toshiaki Iba1, Kohei Okamoto, Shiori Kawasaki
1Department of Emergency and Disaster Medicine, Juntendo University, Hongo, Bunkyo-ku, Japan. toshiiba@cf6.so-net.ne.jp
Background:
Direct hemoperfusion with a polymyxin B-immobilized column (PMX-DHP) is recognized to be effective for the treatment of septic shock and is widely applied in Japan. However, it is still unknown whether the efficacy is limited to cardiovascular dysfunction. Therefore, the purpose of this study was to examine the effects of PMX-DHP on a non-hypotensive sepsis model.
Methods:
Wistar rats were assigned to either a PMX-DHP group, control group, or sham group (n=7 in each group). A sepsis model was made by intravenous infusion of live E. coli. (LD50). The change in systemic blood pressure was less than 20% of the initial level in this model. In the PMX-DHP group, an arteriovenous extracorporeal circuit with a PMX column was applied until 3 h after E. coli injection. The same procedure with a dummy column was applied in the control group. Plasma levels of ALT, LDH, BUN, tumor necrosis factor alpha (TNFα), interleukin (IL)-1β, IL-6, and IL-10 were measured. The mesenteric microcirculation was observed at 1 and 3 h after E. coli injection. In another series, survival was calculated up to 18 h (n=14 in each group).
Results:
Organ damage markers were lower in the PMX-DHP group. The levels of pro-inflammatory cytokines were significantly lower in the PMX-DHP group than in the control group. Microcirculation was better maintained in the PMX-DHP group. Survival was significantly better in the PMX-DHP group (93%) compared with that in the control group (57%, P=0.03).
Conclusions:
PMX-DHP was effective in a non-hypotensive sepsis model.