Outcome of non-surgical septic shock patients treated with polymyxin B hemoperfusion：single center retrospective study

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  • 林 美鈴
    Department of Anesthesiology, Ryukyu University Hospital
  • 神里 興太
    Department of Anesthesiology, Faculty of Medicine, University of the Ryukyus
  • 照屋 孝二
    Department of Anesthesiology, Faculty of Medicine, University of the Ryukyus
  • 渕上 竜也
    Intensive Care Unit, Ryukyu University Hospital
  • 垣花 学
    Department of Anesthesiology, Faculty of Medicine, University of the Ryukyus

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  • 当院においてエンドトキシン吸着療法を施行した内科系敗血症患者の転帰過去５年間の検討

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Abstract

<p>Objectives：To research the efficacy of polymyxin B direct hemoperfusion (PMX-DHP) on non-surgical patients with septic shock.Methods：This was a single center, retrospective study, from January 2012 to January 2016. We extracted data for non-surgical septic shock patients treated with PMX-DHP. The primary outcome was mortality on day 28, and secondary outcomes were reductions of the catecholamine index (CAI), lactate levels, and SOFA score.Results：Overall, in 24 patients, the APACHE II score and SOFA score were 26 (IQR 21-31.25) and 14.5 (IQR 11-17), respectively. The 28-day mortality was 54%. The CAI tended to decrease after PMX-DHP but did not show any significant differences. Patients with decreased CAI presented with a lower 28-day mortality. Any patient who received with PMX-DHP, which started on one day or later after the first administration of antibiotics for septic shock, did not survive. The 28-day mortality was high in patients with low left ventricular ejection fraction.Conclusions：In this retrospective study, PMX-DHP did not show any benefits of assured decreased mortality for non-surgical patients in septic shock. This might be an important finding when PMX-DHP is initiated in patients in septic shock.</p>

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