Descripción de los efectos hemodinámicos y respiratorios del tratamiento mediante hemoperfusión con polimixina B en pacientes con shock séptico de origen abdominal

Navarro, R.; Guerrero, Manuel Cortés; González, Marina Pérez-Flecha; Quecedo, Luis; García, Ana Isabel Morales; Ramasco, F.

doi:10.1016/j.redar.2012.11.006

Cited by 2 publications

(1 citation statement)

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“…Many studies have reported diverse benefits of PMX hemoperfusion in septic patients, including improved hemodynamics [24, 25, 52–60], increased ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO 2 /FiO 2 ) [24, 54, 55, 57, 58, 60, 61], decreased 28-day mortality [24, 52, 53, 59], and decreased endotoxin levels [52, 53, 55, 58, 59, 62–64]. In a multicenter study, Vincent et al [25] found that PMX hemoperfusion was safe and improved cardiac and renal function due to sepsis or septic shock; however, they could not demonstrate a reduction in mortality or in endotoxin levels from baseline to the end of treatment.…”

Section: Immunological Mechanisms Described For Polymyxin B-immobimentioning

confidence: 99%

Immunomodulation in Sepsis: The Role of Endotoxin Removal by Polymyxin B-Immobilized Cartridge

Esteban

Ferrer

Alsina

et al. 2013

Mediators of Inflammation

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Severe sepsis results in high morbidity and mortality. Immunomodulation strategies could be an adjunctive therapy to treat sepsis. Endotoxin is a component of gram-negative bacteria and plays an important role in the pathogenesis of septic shock when it is recognized by immune cells. Removal of endotoxin could be an effective adjunctive approach to the management of sepsis. Devices to adsorb endotoxin or inflammatory cytokines have been designed as a strategy to treat severe sepsis, especially sepsis caused by gram-negative bacteria. Polymyxin B-immobilized cartridge has been successfully used to treat patients with sepsis of abdominal origin. Although this cartridge was conceived to adsorb endotoxin, several other immunological mechanisms have been elucidated, and this device has also yielded promising results in patients with nonseptic respiratory failure. In this paper, we summarize the immune modulation actions of Polymyxin B-immobilized cartridge to explore its potential usefulness beyond endotoxin elimination.

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