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Effects of polymyxin B hemoperfusion on hemodynamics and prognosis in septic shock patients

Chen-Tse Lee1, Yu-Kang Tu2, Yi-Chun Yeh2

  • 1Department of Anesthesiology, National Taiwan University Hospital, No. 7, Chung-Shan S. Road, Taipei, Taiwan, ROC.

Journal of Critical Care
|September 16, 2017
PubMed
Abstract

Insights

Polymyxin B hemoperfusion (PMX-HP) improved hemodynamic status and reduced 28-day mortality in septic shock patients. This treatment shows potential benefits for patients with specific bacterial infections.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Nephrology

Background:

  • Sepsis remains a leading cause of mortality worldwide.
  • Septic shock requires timely and effective interventions to improve patient outcomes.
  • Polymyxin B hemoperfusion (PMX-HP) is an extracorporeal treatment aimed at removing endotoxins.

Purpose of the Study:

  • To evaluate the clinical efficacy of PMX-HP in patients experiencing septic shock.
  • To assess the impact of PMX-HP on hemodynamic parameters and mortality rates.

Main Methods:

  • Retrospective analysis of septic shock patients with intra-abdominal or gram-negative bacterial infections.
  • One-to-one matching between PMX-HP and conventional treatment groups.
  • Comparison of 28-day mortality, inotropic score, SOFA, and APACHE II scores.

Main Results:

  • PMX-HP group showed a significantly greater improvement in inotropic score at 24 hours.
  • Multivariable analysis indicated PMX-HP was associated with reduced 28-day mortality (OR 0.18).
  • PMX-HP demonstrated greater improvement in APACHE II scores compared to the conventional group.

Conclusions:

  • PMX-HP may offer significant hemodynamic and prognostic advantages for septic shock patients.
  • The treatment is particularly beneficial for patients with intra-abdominal or gram-negative bacterial infections.
  • Further prospective studies are warranted to confirm these findings.
Keywords:
Abdominal infectionEndotoxinGram-negative bacteriaPolymyxin B hemoperfusionSeptic shock

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