Web of Science: 3 citations, Scopus: 5 citations, Google Scholar: citations,
Impact of hemoperfusion with polymyxin B added to hemofiltration in patients with endotoxic shock : a case-control study
Navas Pérez, Ana Maria (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Ferrer, Ricard (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Martínez, Maria Luisa (Hospital Universitari General de Catalunya)
Gomà, Gemma (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Gili, Gisela (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Masip, Jordi (Hospital Universitari Sant Joan de Reus (Tarragona))
Suárez, David (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Artigas Raventós, Antoni (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Universitat Autònoma de Barcelona

Date: 2018
Abstract: Septic shock is a leading cause of death in critical patients. In patients with gram-negative septic shock, hemoperfusion with polymyxin B aims to remove endotoxins from plasma. We analyzed the clinical and biological response to hemoperfusion in patients with septic shock and acute kidney injury. This prospective case-control study in the medical-surgical intensive care unit of a university hospital included consecutive adults patients with septic shock and suspected gram-negative bacteria infection with elevated plasma endotoxin activity (EAA > 0. 6 EU/ml) and acute kidney injury requiring continuous renal replacement therapy (CRRT). At onset of septic shock, half underwent CRRT plus hemoperfusion with polymyxin B for two hours a day during two consecutive days (hemoperfusion group) and half received only CRRT (control group). We measured clinical, physiological, and biological parameters (EAA, C-reactive protein, procalcitonin, and cytokines) daily during the first 5 days. We included 18 patients (male, 33%; mean age, 67. 5; mean SOFA score, 11. 3). Abdominal infections predominated (50% had peritonitis). At the beginning of CRRT, RIFLE classification was "failure" for 72% and "injury" for 28%. Baseline characteristics did not differ between groups. Patients in the hemoperfusion group required longer mechanical ventilation (12. 4 vs. 9. 4 days, p = 0. 03) and CRRT (8. 5 vs. 6 days, p = 0. 01) than in the control group. Noradrenaline doses, lactate, procalcitonin, and C-reactive protein decreased in both groups. At day 5, EAA was significantly lower in the hemoperfusion group (0. 58 EU/ml vs. 0. 73 EU/ml in controls, p = 0. 03). There were no significant differences between groups in other biomarkers or ICU mortality (33. 3% in the treatment group vs. 44. 4% in the control group, p = 0. 5). No adverse effects of hemoperfusion were observed. Hemoperfusion with polymyxin B added to CRRT resulted in faster decrease in endotoxin levels, but we observed no improvements in clinical, physiological, or biological parameters. The online version of this article (10. 1186/s13613-018-0465-8) contains supplementary material, which is available to authorized users.
Rights: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Language: Anglès
Document: Article ; recerca ; Versió publicada
Subject: Endotoxic shock ; Hemoperfusion ; Polymyxin B ; Acute kidney injury ; Hemofiltration
Published in: Annals of Intensive Care, Vol. 8 (december 2018) , ISSN 2110-5820

DOI: 10.1186/s13613-018-0465-8
PMID: 30535929


9 p, 990.4 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles

 Record created 2022-02-07, last modified 2023-12-15



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