Exacerbation of prothrombin time-international normalized ratio before second polymyxin B cartridge hemoperfusion predicts poor outcome of patients with severe sepsis and/or septic shock

Ishizuka, Mitsuru; Terasaki, Azusa; Kubota, Keiichi

doi:10.1016/j.jss.2015.07.041

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…Previous research illuminated that coagulation function on ICU admission was associated with mortality in sepsis [ 21 ]. In septic shock, survival curve analysis demonstrated a higher of PT/INR (> 0.16) had significantly higher risk in 28-day mortality compared with a lower level (< 0.16) [ 27 ]. One recent COVID-19 study found that non-survivors with sepsis had higher level of PT and APTT [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Early predicting 30-day mortality in sepsis in MIMIC-III by an artificial neural networks model

Guo

Zhou

et al. 2022

Eur J Med Res

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Objective Early identifying sepsis patients who had higher risk of poor prognosis was extremely important. The aim of this study was to develop an artificial neural networks (ANN) model for early predicting clinical outcomes in sepsis. Methods This study was a retrospective design. Sepsis patients from the Medical Information Mart for Intensive Care-III (MIMIC-III) database were enrolled. A predictive model for predicting 30-day morality in sepsis was performed based on the ANN approach. Results A total of 2874 patients with sepsis were included and 30-day mortality was 29.8%. The study population was categorized into the training set (n = 1698) and validation set (n = 1176) based on the ratio of 6:4. 11 variables which showed significant differences between survivor group and nonsurvivor group in training set were selected for constructing the ANN model. In training set, the predictive performance based on the area under the receiver-operating characteristic curve (AUC) were 0.873 for ANN model, 0.720 for logistic regression, 0.629 for APACHEII score and 0.619 for SOFA score. In validation set, the AUCs of ANN, logistic regression, APAHCEII score, and SOFA score were 0.811, 0.752, 0.607, and 0.628, respectively. Conclusion An ANN model for predicting 30-day mortality in sepsis was performed. Our predictive model can be beneficial for early detection of patients with higher risk of poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Early predicting 30-day mortality in sepsis in MIMIC-III by an artificial neural networks model

Guo

Zhou

et al. 2022

Eur J Med Res

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“…In our settings, we applied PMX-HP for 3 h, for two subsequent days. In an interesting recent trial [ 27 ], sequential estimation of PT-international normalized ratio (INR) was a strong predictor of the efficacy of treatment. Additionally, exacerbation of PT-INR (>0.16) before a second PMX-HP session was the most important predictor for 28-day mortality and futility of treatment.…”

Section: Discussionmentioning

confidence: 99%

The effects of direct hemoperfusion using a polymyxin B-immobilized column in a pig model of severe Pseudomonas aeruginosa pneumonia

Bassi

Martí

Xiol

et al. 2016

Ann. Intensive Care

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BackgroundHemoperfusion through a column containing polymyxin B-immobilized fiber (PMX-HP) is beneficial in abdominal sepsis. We assessed the effects of PMX-HP in a model of severe Pseudomonas aeruginosa pneumonia.MethodsEighteen pigs with severe P. aeruginosa pneumonia were mechanically ventilated for 76 h. Pigs were randomized to receive standard treatment with fluids and vasoactive drugs, or standard treatment with two 3-h PMX-HP sessions. Antibiotics against P. aeruginosa were never administered. We assessed endotoxemia through the endotoxin activity assay (EA). We measured the static lung elastance, ratio of arterial partial pressure per inspiratory fraction of oxygen (PaO2/FIO2), mean arterial pressure, cardiac output, systemic vascular resistance and inotropic score. Finally, every 24 h, we assessed complete blood count.ResultsIn comparison with the control group, PMX-HP decreased percentage of circulating neutrophils from 47.4 ± 13.8 to 40.8 ± 11.5 % (p = 0.009). In a subgroup of animals with the worst hemodynamic impairment, EA in the control and PMX-HP groups was 0.50 ± 0.29 and 0.29 ± 0.14, respectively (p = 0.018). Additionally, in the control and PMX-HP groups, static lung elastance was 26.9 ± 8.7 and 25.3 ± 7.5 cm H2O/L (p = 0.558), PaO2/FIO2 was 347.3 ± 61.9 and 356.4 ± 84.0 mmHg (p = 0.118), mean arterial pressure was 81.2 ± 10.3 and 81.6 ± 13.1 mmHg (p = 0.960), cardiac output was 3.30 ± 1.11 and 3.28 ± 1.19 L/min (p = 0.535), systemic vascular resistance was 1982.6 ± 608.4 and 2011.8 ± 750.0 dyne/s/cm–5 (p = 0.939), and inotropic score was 0.25 ± 0.10 and 0.26 ± 0.18 (p = 0.864).ConclusionsIn mechanically ventilated pigs with severe P. aeruginosa pneumonia, PMX-HP does not have any valuable clinical benefit, and studies are warranted to fully evaluate a potential role of PMX-HP in septic shock associated with severe pulmonary infections.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-016-0155-3) contains supplementary material, which is available to authorized users.

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Exacerbation of prothrombin time-international normalized ratio before second polymyxin B cartridge hemoperfusion predicts poor outcome of patients with severe sepsis and/or septic shock

Cited by 2 publications

References 26 publications

Early predicting 30-day mortality in sepsis in MIMIC-III by an artificial neural networks model

Early predicting 30-day mortality in sepsis in MIMIC-III by an artificial neural networks model

The effects of direct hemoperfusion using a polymyxin B-immobilized column in a pig model of severe Pseudomonas aeruginosa pneumonia

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