Association of type II secretory phospholipase A<sub>2</sub> and surfactant protein D with the pulmonary oxygenation potential in patients with septic shock during polymyxin‐B immobilized fiber‐direct hemoperfusion

Ishibe, Y; Shibata, Shigehiro; Takahashi, Goro; Suzuki, Yasushi; Inoué, Yoshihiro; Endo, Shunsuke

doi:10.1002/jca.21507

Cited by 8 publications

(6 citation statements)

References 40 publications

(36 reference statements)

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“…i) Phospholipase A 2 releases phospholipids that are metabolized through the enzyme system of the cyclooxygenases and lipooxigenesis in prostaglandins and leukotrienes ( 39 ). These substances determine fever (especially prostaglandin PGE 1 with effect the hypothalamus), vasodilation with increased cellular permeability ( 40 ). ii) The Hageman factor determines the initiation of the coagulation cascade and the activation of the quinine system.…”

Section: The Septic Syndromementioning

confidence: 99%

Molecular mechanisms in septic shock (Review)

et al. 2021

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Sepsis is a clinical syndrome defined by the presence of infection and systemic inflammatory response to infection and results from a complex interaction between the host and infectious agents. It is characterized by the activation of multiple inflammatory pathways, with an increased risk of mortality. The incidence of sepsis has been on an ever-increasing pathway in recent years. Sepsis can be induced by several clinical situations that predispose to its occurrence: malignant tumors, organ transplantation, AIDS, radiation therapy, burns, sores, polytrauma, diabetes mellitus, hepatic failure, renal failure, malnutrition, catheters or different invasive devices, and urinary catheters. The microorganisms involved in the pathogenesis of sepsis are Gram-positive cocci ( Staphylococci , Streptococci ) and Gram-negative bacilli ( Klebsiella, Pseudomonas aeruginosa , E. coli ), fungi ( Candida ), parasites, and viruses. Among mechanisms involved in septic shock production, two pathological phenomena appear: the profound decompensation of circulation and metabolic disturbances that evolve towards an irreversible state. The intimate mechanism of shock involves the activation of monocytes, macrophages and neutrophils by lipopolysaccharides of Gram-negative bacteria. The microvascular bed is directly involved in the etiopathogenesis of disorders of acute inflammatory states associated with or without sepsis. A better comprehension of sepsis pathophysiology, especially the molecular mechanisms of septic shock, allows for new therapeutic perspectives.

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Section: The Septic Syndromementioning

confidence: 99%

Molecular mechanisms in septic shock (Review)

et al. 2021

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“…The first session of PMX‐DHP was started within 6 h of diagnosing patients with septic shock, with the duration of individual PMX‐DHP sessions ranging from 2 to 6 h depending on the patient’s condition . Our systolic blood pressure target was 120 mm Hg after 2 h of PMX‐DHP.…”

Section: Methodsmentioning

confidence: 99%

“…Endotoxin was measured immediately after obtaining the platelet‐rich plasma sample . Plasma endotoxin level was measured through a high‐sensitivity method (endotoxin‐specific turbidimetric time assay) using a Toxinometer ET‐500 (Wako Pure Chemical Industries, Ltd., Osaka, Japan), with a cutoff level for diagnosing endotoxemia set at 1.1 pg./mL .…”

Section: Methodsmentioning

confidence: 99%

Clinical Effects of Polymyxin B Hemoperfusion in Patients With Septic Shock Caused by Urinary Tract Infection

et al. 2018

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Direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) has been widely used for severe sepsis and septic shock. However, data are limited regarding the clinical experience and efficacy of PMX-DHP for septic shock resulting from urinary tract infection (UTI). At our institution, 15 patients with septic shock resulting from a UTI received PMX-DHP from January 2013 to July 2017. The cause of the urosepsis was mainly obstructive pyelonephritis secondary to ureterolithiasis or neurogenic bladder. Average Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 25.9 ± 4.3 and 10.5 ± 2.2, respectively. If patients were still hypotensive after initial resuscitation, we began PMX-DHP. Mean arterial pressure increased significantly from 58.3 ± 9.6 mm Hg to 93.6 ± 14.8 mm Hg just after PMX-DHP and to 94.7 ± 16.9 mm Hg (P < 0.0001) 24 h after the treatment. Catecholamine index decreased significantly from 20.7 ± 11.3 to 9.3 ± 13.5 (P = 0.0001) 24 h after the treatment. Of 15 patients, 14 (93.3%) had survived 28 days after admission. Our results suggest a possible role for PMX-DHP in the rapid stabilization of hemodynamics in patients with septic shock with an underlying UTI. These patients may be good candidates for PMX-DHP.

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“…Ishibe et al found that the plasma levels of type II secretory phospholipase A2 (sPLA2-II) and surfactant protein-D (SP-D) in patients with septic ARDS are simultaneously elevated with inflammatory cytokine levels (e.g., TNF-α and IL-8) [ 32 ]. sPLA2-II, excreted into the alveoli by macrophages and mast cells, plays an important role in the development of respiratory dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Potential survival benefit and early recovery from organ dysfunction with polymyxin B hemoperfusion: perspectives from a real-world big data analysis and the supporting mechanisms of action

Shoji

Ferrer

2022

J Anesth Analg Crit Care

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Background Endotoxin (ET) removal therapy with polymyxin B-immobilized fiber column hemoperfusion (PMX-HP) has been used for the treatment of septic shock. Some observational studies reported clinical benefits, particularly in specific subgroups of patients. However, larger randomized controlled trial results have been disappointing. Main body The four studies that revealed the survival benefit of PMX-HP were based on the Japanese Diagnosis Procedure Combination (DPC) national inpatient database (J-DPC study). Nevertheless, one J-DPC study and a randomized controlled trial (RCT) conducted in France evaluated PMX-HP in patients with abdominal septic shock and did not report a significant survival benefit. In both studies, the severity of illness was too low to find substantial significant differences in mortality. The results of the J-DPC studies further suggest that some subpopulations of patients could benefit from PMX-HP. Based on these results, this review revisited prior RCTs and other large-scale studies on PMX-HP. In addition, four J-DPC studies and one large-scale study reported a survival benefit with PMX-HP. A secondary analysis of the EUPHRATES trial, the most recent double-blinded RCT of PMX-HP conducted in North America, suggested a survival benefit in patients with high levels of endotoxemia. In the J-DPC studies and the EUPHRATES trial, ventilator-free days, vasoactive drug-free days, and renal replacement-free days were significantly improved in the PMX-HP groups. These findings suggest that PMX-HP can contribute to early recovery from organ dysfunction. The reduction of supportive care likely provides important health and economic benefits for managing patients with septic shock. Finally, the blood levels of mediators or biomarkers related to respiratory, cardiovascular, and renal dysfunction have been reported to be normalized with PMX-HP. Conclusions These results support the biological rationale for the improvement in organ dysfunction observed in the J-DPC studies and other large-scale studies, including the EUPHRATES trial. Real-world evidence from large data sets suggests an appropriate patient population that are likely to benefit from the utility of PMX-HP for septic shock.

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Association of type II secretory phospholipase A₂ and surfactant protein D with the pulmonary oxygenation potential in patients with septic shock during polymyxin‐B immobilized fiber‐direct hemoperfusion

Cited by 8 publications

References 40 publications

Molecular mechanisms in septic shock (Review)

Molecular mechanisms in septic shock (Review)

Clinical Effects of Polymyxin B Hemoperfusion in Patients With Septic Shock Caused by Urinary Tract Infection

Potential survival benefit and early recovery from organ dysfunction with polymyxin B hemoperfusion: perspectives from a real-world big data analysis and the supporting mechanisms of action

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Association of type II secretory phospholipase A2 and surfactant protein D with the pulmonary oxygenation potential in patients with septic shock during polymyxin‐B immobilized fiber‐direct hemoperfusion

Cited by 8 publications

References 40 publications

Molecular mechanisms in septic shock (Review)

Molecular mechanisms in septic shock (Review)

Clinical Effects of Polymyxin B Hemoperfusion in Patients With Septic Shock Caused by Urinary Tract Infection

Potential survival benefit and early recovery from organ dysfunction with polymyxin B hemoperfusion: perspectives from a real-world big data analysis and the supporting mechanisms of action

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Association of type II secretory phospholipase A₂ and surfactant protein D with the pulmonary oxygenation potential in patients with septic shock during polymyxin‐B immobilized fiber‐direct hemoperfusion