Effects of polymyxin B hemoperfusion on hemodynamics and prognosis in septic shock patients
Journal
Journal of Critical Care
Journal Volume
43
Journal Volume
43
Pages
202-206
Start Page
202
End Page
206
Date Issued
2018
Author(s)
Yeh, Yi-Chun
Chang, Tzu
Abstract
Purpose We designed this study to examine the clinical effects of polymyxin B hemoperfusion (PMX-HP) in septic shock patients. Material and methods We retrospectively examined the effects of PMX-HP in septic shock patients with intra-abdominal or gram-negative bacterial infection during October 2013–May 2016. A one-to-one matching between the PMX-HP and conventional groups was performed, and 28-day mortality, and change in inotropic score, Sequential Organ Failure Assessment (SOFA) score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24 h in the two groups were compared. In addition, multivariable regression analysis and Cox proportional hazards regression model were applied in all eligible patients. Results Sixty-nine patients were eligible, of whom fifty patients were enrolled for matched cohort analysis. In matched cohort analysis, change in inotropic score after 24 h (? 24.8 [19.7] vs. ? 6.4 [20.0], p = 0.002) differed significantly between the PMX-HP and conventional groups. Multivariable regression analysis revealed that PMX-HP was associated with lower 28-day mortality (odds ratio 0.18, 95% CI 0.04–0.92, p = 0.039) and greater improvement in inotropic and APACHE II scores. Conclusions PMX-HP may have potential benefits for hemodynamic and prognostic outcomes in septic shock patients with intra-abdominal or gram-negative bacterial infection. ? 2017
Subjects
Abdominal infection; Endotoxin; Gram-negative bacteria; Polymyxin B hemoperfusion; Septic shock
SDGs
Other Subjects
polymyxin B; antiinfective agent; polymyxin B; abdominal infection; adult; aged; APACHE; Article; cohort analysis; controlled study; drug effect; female; Gram negative infection; hemodynamics; hemoperfusion; human; major clinical study; male; mortality; prognosis; retrospective study; septic shock; Sequential Organ Failure Assessment Score; treatment outcome; clinical trial; Gram negative infection; hemoperfusion; multicenter study; organ dysfunction score; prognosis; septic shock; Taiwan; Aged; Anti-Bacterial Agents; APACHE; Cohort Studies; Female; Gram-Negative Bacterial Infections; Hemoperfusion; Humans; Male; Organ Dysfunction Scores; Polymyxin B; Prognosis; Retrospective Studies; Shock, Septic; Taiwan
Type
journal article