Endotoxin removal by direct hemoperfusion with an adsorbent column using polymyxin B-immobilized fiber ameliorates systemic circulatory disturbance in patients with septic shock

Uriu, Kohei; Osajima, Akihiko; Hiroshige, Kinya; Watanabe, Hiroyuki; Aibara, Keiji; Inada, Y; Segawa, Keiko; Anai, Hiroshi; Takagi, Ichiro; Ito, Aki; Kamochi, Masayuki; Kaizu, Kazo

doi:10.1053/ajkd.2002.32767

Cited by 54 publications

(43 citation statements)

References 37 publications

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“…Several preclinical studies have demonstrated that hemoperfusion or plasmapheresis over immobilized polymyxin B can remove endotoxin from the blood [12][13][14] . Recently, some studies reported improved hemodynamic status [15] and improved survival [16] in patients with sepsis treated with PMX, and DHP-PMX therapy is effective for patients with septic shock who are infected not only by gram-negative bacteria but also by gram-positive bacteria without endotoxin release [17] . Therefore, DHP-PMX therapy has been conventionally used in patients with severe sepsis or septic shock, and its clinical effect has been confirmed.…”

Section: Discussionmentioning

confidence: 99%

Direct hemoperfusion with a polymyxin B-immobilized cartridge in intestinal warm ischemia reperfusion

Sato¹,

Oshima²,

Arakawa³

et al. 2008

WJG

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AIM:To investigate the effectiveness of direct hemoperfusion with polymyxin B-immobilized fibers (DHP-PMX therapy) on warm ischemia-reperfusion (I/R) injury of the small intestine. METHODS:The proximal jejunum and distal ileum of mongrel dogs were resected. Warm ischemia was performed by clamping the superior mesenteric artery (SMA) and vein (SMV) for 2 h. Blood flow to the proximal small intestine was restored 1 h after reperfusion, and the distal small intestine was used as a stoma. The experiment was discontinued 6 h after reperfusion. The dogs were divided into two groups: the DHP-PMX group (n = 6, DHP-PMX was performed for 180 min; from 10 min prior to reperfusion to 170 min after reperfusion) and the control group (n = 5). The rate pressure product (RPP), SMA blood flow, mucosal tissue blood flow, and intramucosal pH (pHi) were compared between the two groups. The serum interleukin (IL)-10 levels measured 170 min after reperfusion were also compared. RESULTS: The RPP at 6 h after reperfusion was significantly higher in the PMX group than in the control group (12 174 ± 1832 mmHg/min vs 8929 ± 1797 mmHg/min, P < 0.05). The recovery rates of the SMA blood flow at 1 and 6 h after reperfusion were significantly better in the PMX group than in the control group (61% ± 7% vs 44% ± 4%, P < 0.05, and 59% ± 5% vs 35% ± 5%, P < 0.05, respectively).The recovery rate of the mucosal tissue blood flow and the pHi levels at 6 h after reperfusion were significantly higher in the PMX group (61% ± 8% vs 31% ± 3%, P < 0.05 and 7.91 ± 0.06 vs 7.69 ± 0.08, P < 0.05, respectively). In addition, the serum IL-10 levels just before DHP-PMX removal were significantly higher in the PMX group than in the control group (1 569 ± 253 pg/mL vs 211 ± 40 pg/mL, P < 0.05).

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Section: Discussionmentioning

confidence: 99%

Direct hemoperfusion with a polymyxin B-immobilized cartridge in intestinal warm ischemia reperfusion

Sato¹,

Oshima²,

Arakawa³

et al. 2008

WJG

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“…Numerous techniques have been tested to remove circulating inflammatory cytokines from patient blood, as well as remove endotoxin. Polymyxin-B has been studied as an endotoxin binder, due to its affinity to the lipid A component and as it disrupts the permeability of cytoplasmic membranes of Gram negative bacteria (Uriu et al, 2002;Jaber & Pereira, 1997;Tani et al, 1998). Polyethylenimine has been researched as a potential endotoxin adsorbent, and may be more compatible than other types of resins in similar applications (Mitzner et al, 1993).…”

Section: Membrane Coatingsmentioning

confidence: 99%

Dialysis Membrane Manipulation for Endotoxin Removal

Henrie¹,

Ford²,

Stroup³

et al. 2011

Progress in Hemodialysis - From Emergent Biotechnology to Clinical Practice

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“…Recently, some studies have shown improved hemodynamic status [17] and survival [18] in patients with sepsis who were treated with PMX. Moreover, DHP-PMX therapy was found to be effective for patients with septic shock infected with either Gramnegative or Gram-positive bacteria, which do not release endotoxins [19] .…”

Section: Sato H Et Al Pmx Therapy Improves Liver Function After I/rmentioning

confidence: 99%

Hemoperfusion with polymyxin B-immobilized fiber column improves liver function after ischemia-reperfusion injury

Sato¹,

Oshima²,

Kobayashi³

et al. 2009

WJG

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AIM:To investigate the usefulness of direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX therapy) for warm hepatic ischemia-reperfusion (I/R) injury after total hepatic vascular exclusion (THVE) using a porcine model. METHODS:Eleven Mexican hairless pigs weighing 22-38 kg were subjected to THVE for 120 min and then observed for 360 min. The animals were divided into two groups randomly: the DHP-PMX group (n = 5) underwent DHP-PMX at a flow rate of 80 mL/min for 120 min (beginning 10 min before reperfusion), while the control group did not (n = 6). The rate pressure product (RPP): heart rate × end-systolic arterial blood pressure, hepatic tissue blood flow (HTBF), portal vein blood flow (PVBF), and serum aspartate aminotransferase (AST) levels were compared between the two groups.RESULTS: RPP and HTBF were significantly (P < 0.05) higher in the DHP-PMX group than in the control group 240 and 360 min after reperfusion. PVBF in the DHP-PMX group was maintained at about 70% of the flow before ischemia and differed significantly (P < 0.05) compared to the control group 360 min after reperfusion. The serum AST increased gradually after reperfusion in both groups, but the AST was significantly (P < 0.05) lower in the DHP-PMX group 360 min after reperfusion.CONCLUSION: DHP-PMX therapy reduced the hepatic warm I/R injury caused by THVE in a porcine model.

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Endotoxin removal by direct hemoperfusion with an adsorbent column using polymyxin B-immobilized fiber ameliorates systemic circulatory disturbance in patients with septic shock

Cited by 54 publications

References 37 publications

Direct hemoperfusion with a polymyxin B-immobilized cartridge in intestinal warm ischemia reperfusion

Direct hemoperfusion with a polymyxin B-immobilized cartridge in intestinal warm ischemia reperfusion

Dialysis Membrane Manipulation for Endotoxin Removal

Hemoperfusion with polymyxin B-immobilized fiber column improves liver function after ischemia-reperfusion injury

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