https://scholars.lib.ntu.edu.tw/handle/123456789/514957
標題: | Effects of endotoxin adsorber hemoperfusion on sublingual microcirculation in patients with septic shock: a randomized controlled trial | 作者: | SHIH-HONG CHEN Chan W.-S. CHIH-MIN LIU Chiu C.-T. ANNE CHAO VIN-CENT WU WANG-HUEI SHENG Lai C.-H. MING-JIUH WANG YU-CHANG YEH |
公開日期: | 2020 | 出版社: | Springer | 卷: | 10 | 期: | 1 | 起(迄)頁: | 80 | 來源出版物: | Annals of Intensive Care | 摘要: | Background: Endotoxins can induce an excessive inflammatory response and result in microcirculatory dysfunction. Polymyxin-B hemoperfusion (PMX-HP) has been recognized to effectively remove endotoxins in patients with sepsis and septic shock, and a rat sepsis model revealed that PMX-HP treatment can maintain a better microcirculation. The primary aim of this study was to investigate the effect of PMX-HP on microcirculation in patients with septic shock. Methods: Patients with septic shock were enrolled and randomized to control and PMX-HP groups. In the PMX-HP group, patients received the first session of PMX-HP in addition to conventional septic shock management within 24?h after the onset of septic shock; the second session of PMX-HP was provided after another 24?h as needed. Results: Overall, 28 patients finished the trial and were analyzed. The mean arterial pressure and norepinephrine infusion dose did not differ significantly between the control and PMX-HP groups after PMX-HP treatment. At 48?h after enrollment, total vessel density (TVD) and perfused vessel density (PVD) were higher in the PMX-HP group than in the control group [TVD 24.2 (22.1–24.9) vs. 21.1 (19.9–22.9)?mm/mm2; p = 0.007; PVD 22.9 (20.9–24.9) vs. 20.0 (18.9–21.6)?mm/mm2, p = 0.008]. Conclusions: This preliminary study observed that PMX-HP treatment improved microcirculation but not clinical outcomes in patients with septic shock at a low risk of mortality. Nevertheless, larger multicenter trials are needed to confirm the effect of PMX-HP treatment on microcirculation in patients with septic shock at intermediate- and high-risk of mortality. Trial registration ClinicalTrials.gov protocol registration ID: NCT01756755. Date of registration: December 27, 2012. First enrollment: October 6, 2013. https://clinicaltrials.gov/ct2/show/NCT01756755. ? 2020, The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85086337691&doi=10.1186%2fs13613-020-00699-z&partnerID=40&md5=85f8fc2be9b6ccf381d6b457c90bf5d0 https://scholars.lib.ntu.edu.tw/handle/123456789/514957 |
ISSN: | 2110-5820 | DOI: | 10.1186/s13613-020-00699-z | SDG/關鍵字: | endotoxin; polymyxin B; aged; Article; blood vessel parameters; controlled study; female; hemoperfusion; human; major clinical study; male; microcirculation; mouth floor; perfused vessel density; priority journal; prospective study; randomized controlled trial; septic shock; total vessel density |
顯示於: | 醫學系 |
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