Continuous Hemodiafiltration with Polymyxin‐B Immobilized Fiber Is Effective in Patients with Sepsis Syndrome and Acute Renal Failure

Abstract

The aim of this study was first, to evaluate the effects of continuous hemodiafiltration (CHDF) alone or combined with CHDF and polymyxin-B immobilized fiber (PMX) on survival rates of patients with sepsis and acute renal failure, and second, to evaluate the changes in plasma levels of inflammatory cytokines before and after treatment with CHDF and PMX and CHDF alone in these patients. Forty-eight patients with septic shock and acute renal failure were enrolled in this study. The survival rate of all patients at 28 days was 25% for those with CHDF and 75% for those with PMX and CHDF treatment. Combination treatment produced a significant reduction of plasma levels of endotoxin and interleukin-6 compared to the basal values and to the treatment with CHDF alone. From these data, it is suggested that the combined therapy with PMX and CHDF is effective in improvement of survival rate of patients with septic shock and acute renal failure.

Direct Hemoperfusion Using Polymyxin-B Immobilized Fiber for Septic Shock After Cardiac Surgery

“…PMX-DHP is an effective radical treatment for septic shock. However, although it was reported that PMX-DHP improved lung function in acute lung injury and acute respiratory distress syndrome, 12 and renal function in combination with CHDF in acute renal failure, 13 those effects were not observed in the present study.…”

Anandamide absorption by direct hemoperfusion with polymixin B-immobilized fiber improves the prognosis and organ failure assessment score in patients with sepsis

“…Various new technologies, including plasma exchange, continuous hemofiltration, continuous hemodiafiltration, and PMX-DHP, have been reported to be useful methods for removal of these humoral mediators from blood, resulting in the improvement of prognosis [1,10,[23][24][25]. PMX-DHP was originally developed for selective adsorption of endotoxin in patients with Gram-negative bacterial infection [1][2][3].…”

New Trends in Polymyxin B Hemoperfusion: From 2006 to 2013

“…Reduced levels of a number of other mediators have been reported after PMX. The list includes IL-6 [12,13,14], IL-10 [13,14], IL-18 [15], TNF-α [14,16], metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 [7], plasminogen activator inhibitor-1 [14,16,17], neutrophil elastase [9,18], platelet factor-4 [15], β-thromboglobulin [15], soluble P selectin [15] and endogenous cannabinoids [15,19] such as anandamide. Several of these mediators cause lung injury, increase vascular permeability and worsen intrapulmonary shunting.…”