Effect of PMX‐DHP for sepsis due to ESBL‐producing <i>E</i>. <i>coli</i> in an extremely low‐birthweight infant

Nishizaki, Naoto; Nakagawa, Mayu; Hara, Satoshi; Oda, Hisayuki; Kantake, Masato; Obinata, Kaoru; Uehara, Yuki; Hiramatsu, Kazumasa; Shimizu, Toshiaki

doi:10.1111/ped.12825

Cited by 18 publications

(13 citation statements)

References 13 publications

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“…Thus, strategies aimed at controlling the host response are important. Since the 2000s, polymyxin-B immobilized column-direct hemoperfusion (PMX-DHP) has been reported for neonatal and pediatric septic shock following its use in adults [7][8][9][10][11][12][13][14][15]. However, because there are no randomized Fig.…”

Section: Discussionmentioning

confidence: 99%

Effects of continuous renal replacement therapy with the AN69ST membrane for septic shock and sepsis-induced AKI in an infant: a case report with literature review of cytokine/mediator removal therapy in children

et al. 2020

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Background: Septic shock is a life-threatening condition and one of the most common causes of acute kidney injury (AKI). The acrylonitrile-co-methallyl sulfonate surface-treated (AN69ST) membrane used in severe sepsis was formally launched in Japan in 2014, as a non-renal indication. This membrane provides hemofiltration in dialysis and improves hemodynamics in patients with sepsis and hypercytokinemia. However, the clinical literature regarding continuous renal replacement therapy (CRRT) with the AN69ST membrane is very limited, especially in infants. Case presentation: A 3-month-old female infant weighing 4.2 kg was hospitalized for septic shock and AKI secondary to necrotizing enterocolitis. Although she underwent palliative surgery, her vital signs did not recover from shock, and she developed reduced urine output. Her pediatric sequential organ failure assessment score was 10 points. Thus, we strongly suspected septic shock and sepsis-induced AKI, which were refractory to conservative treatment, and we decided to introduce CRRT with the AN69ST membrane for both renal replacement and antihypercytokinemic indications. After initiating CRRT for 72 h, her blood pressure increased sufficiently to maintain urine output, and improvements in the electrolyte abnormalities and metabolic acidosis were observed. Notably, her serum inflammatory cytokine levels decreased in parallel with improvement in her general condition. Despite successfully recovering from the AKI and being stable enough to allow discontinuing CRRT, she died of multiple organ dysfunction syndrome 3 weeks after CRRT was discontinued.

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Section: Discussionmentioning

confidence: 99%

Effects of continuous renal replacement therapy with the AN69ST membrane for septic shock and sepsis-induced AKI in an infant: a case report with literature review of cytokine/mediator removal therapy in children

et al. 2020

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“…I note that Kim et al [1] did not report the patient's IL-6 level as a measure of the severity of septic shock. IL-6 is considered useful as a marker of shock and a criterion for induction of PMX-DHP in sick neonates [3,4].…”

Section: Pissn 2586-6052 | Eissn 2586-6060mentioning

confidence: 99%

Suggestions and tips regarding polymyxin B-immobilized fiber column direct hemoperfusion of neonates with sepsis

Nishizaki¹

2020

Acute Crit Care

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“…Several reports in Japanese literature have shown acceptable results by using PMX-05R in pediatric or elderly patients with sepsis. In 2011, PMX-01R was released for use in newborn or premature babies, and there are case reports describing the clinical use of PMX- 01R in patients with a body weight less than 1000 g with severe sepsis [27,28].…”

Section: Toraymyxin As a Medical Devicementioning

confidence: 99%

Anti-endotoxin Properties of Polymyxin B-immobilized Fibers

Tani

Shimizu

Tani

et al. 2019

Advances in Experimental Medicine and Biology

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Polymyxin B is an antibiotic that shows strong bactericidal activity against Gram-negative bacteria, by binding to and inactivating endotoxin. Systemic administration of polymyxin B in humans is restricted because of its nephrotoxicity and neurotoxicity, and this compound was therefore considered a strong candidate ligand for the extracorporeal selective adsorption of circulating endotoxin in the blood. Toraymyxin® is a direct hemoperfusion column that uses polymyxin B attached to an insoluble carrier to bind endotoxin in the blood. In 1994, the Japanese National Health Insurance system approved the use of Toraymyxin for the treatment of endotoxemia and septic shock. In this chapter, we will review the development, clinical use, and efficacy of Toraymyxin, examine the structure of the Toraymyxin column, and comment on the current position of Toraymyxin in the treatment of severe sepsis and septic shock. We will also highlight some potential new applications of Toraymyxin for pulmonary diseases.

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Effect of PMX‐DHP for sepsis due to ESBL‐producing E. coli in an extremely low‐birthweight infant

Cited by 18 publications

References 13 publications

Effects of continuous renal replacement therapy with the AN69ST membrane for septic shock and sepsis-induced AKI in an infant: a case report with literature review of cytokine/mediator removal therapy in children

Effects of continuous renal replacement therapy with the AN69ST membrane for septic shock and sepsis-induced AKI in an infant: a case report with literature review of cytokine/mediator removal therapy in children

Suggestions and tips regarding polymyxin B-immobilized fiber column direct hemoperfusion of neonates with sepsis

Anti-endotoxin Properties of Polymyxin B-immobilized Fibers

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