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Intraoperative direct hemoperfusion with a polymyxin-B immobilized fiber column for treatment of infective

Toshinori Totsugawa1, Masahiko Kuinose, Hidenori Yoshitaka

  • 1Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, 2-1-10 Marunouchi, Okayama 700-0823, Japan. toshinoritotsugawa@mac.com

General Thoracic and Cardiovascular Surgery
|February 11, 2011
PubMed
Abstract

Insights

Intraoperative polymyxin-B hemoperfusion (PMX-DHP) significantly improved outcomes for patients undergoing surgery for infective endocarditis (IE). This endotoxin adsorption therapy reduced the need for inotropic agents and shortened recovery times.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Endotoxin adsorption therapy, specifically polymyxin-B direct hemoperfusion (PMX-DHP), is established for severe sepsis.
  • The effectiveness of PMX-DHP in infective endocarditis (IE), often caused by gram-positive bacteria, is not well-defined.

Purpose of the Study:

  • To evaluate the impact of intraoperative PMX-DHP on clinical outcomes in patients with active IE undergoing emergent surgery.

Main Methods:

  • A comparative study of 11 patients receiving intraoperative PMX-DHP during IE surgery (2006-2009) versus 7 patients treated conventionally (2003-2006).

Main Results:

  • PMX-DHP group showed significantly reduced postoperative catecholamine requirements and shorter intubation and ICU stays.
  • A notable difference in the number of postoperative organ failures was observed between the groups.

Conclusions:

  • Intraoperative PMX-DHP offers benefits for emergent IE surgery, including reduced inotropic agent use and mechanical ventilation duration.
  • PMX-DHP is a potentially valuable treatment option for critically ill IE patients.

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