Treatment of Pyonephritis Complicated by Septic Shock Using Extracorporeal Device Polymyxin B-Hemoperfusion

Direct hemoperfusion using polymyxin B-immobilized fiber (PMX-DHP) is an established treatment method for septic shock caused by Gram-negative infections. We report one instance in which PMX-DHP therapy has been used successfully in a 33-year-old woman with septic shock from urosepsis. Although there is lack of recommendations in latest Surviving Sepsis Campaign Guidelines, evidence of PMX-DHP efficacy in this subset of patients is growing.

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Polymyxin B Hemoperfusion in Pneumonic Septic Shock Caused by Gram-Negative Bacteria

Korean Journal of Critical Care Medicine ◽

10.4266/kjccm.2015.30.3.171 ◽

2015 ◽

Vol 30 (3) ◽

pp. 171-175

Author(s):

Jung-Wan Yoo ◽

Su Yeon Park ◽

Jin Jeon ◽

Jin Won Huh ◽

Chae-Man Lim ◽

...

Keyword(s):

Septic Shock ◽

Polymyxin B ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Polymyxin B Hemoperfusion

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Direct hemoperfusion with a polymyxin B column versus vasopressin for gram negative septic shock: a matched cohort study of the effect on survival

Clinical Nephrology ◽

10.5414/cn107584 ◽

2013 ◽

Vol 79 (06) ◽

pp. 463-470 ◽

Cited By ~ 3

Author(s):

Naoki Sawa ◽

Yoshibumi Ubara ◽

Keiichi Sumida ◽

Rikako Hiramatsu ◽

Eiko Hasegawa ◽

...

Keyword(s):

Septic Shock ◽

Cohort Study ◽

Polymyxin B ◽

Matched Cohort ◽

Direct Hemoperfusion ◽

Gram Negative ◽

Matched Cohort Study

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The Severity of Hyperdynamic Circulation May Predict the Effects of Direct Hemoperfusion with the Adsorbent Column Using Polymyxin B-Immobilized Fiber in Patients with Gram-Negative Septic Shock

Therapeutic Apheresis and Dialysis ◽

10.1046/j.1526-0968.2001.005001025.x ◽

2001 ◽

Vol 5 (1) ◽

pp. 25-30 ◽

Cited By ~ 8

Author(s):

Kohei Uriu ◽

Akihiko Osajima ◽

Masayuki Kamochi ◽

Hiroyuki Watanabe ◽

Keiji Aibara ◽

...

Keyword(s):

Septic Shock ◽

Polymyxin B ◽

Direct Hemoperfusion ◽

Gram Negative ◽

Hyperdynamic Circulation

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Faculty Opinions recommendation of Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1163099.623758 ◽

2009 ◽

Author(s):

Martin Duenser

Keyword(s):

Septic Shock ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Polymyxin B ◽

Randomized Controlled ◽

Early Use ◽

Polymyxin B Hemoperfusion

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Effects of Polymyxin B Hemoperfusion on Septic Shock Patients Requiring Noradrenaline: Analysis of a Nationwide Administrative Database in Japan

Blood Purification ◽

10.1159/000513213 ◽

2021 ◽

pp. 1-6

Author(s):

Kenji Fujimori ◽

Kunio Tarasawa ◽

Kiyohide Fushimi

Keyword(s):

Septic Shock ◽

Propensity Score ◽

Propensity Score Matching ◽

Polymyxin B ◽

Administrative Database ◽

Control Group ◽

Continuous Hemodiafiltration ◽

Significant Survival ◽

Maximum Daily Dose ◽

Polymyxin B Hemoperfusion

Introduction: Polymyxin B hemoperfusion (PMX) reduces endotoxin in septic shock patients’ blood and can improve hemodynamics and organ functions. However, its effects on the reduction of septic shock mortality are controversial. Methods: Using the Japanese diagnosis procedure combination database from April 2016 to March 2019, we identified adult septic shock patients treated with noradrenaline. This study used propensity score matching to compare the outcome between PMX-treated and non-treated patients. The primary endpoint was 28-day mortality, counting from the day of noradrenaline initiation. The secondary endpoints were noradrenaline-, ventilator-, and continuous hemodiafiltration (CHDF)-free days at day 28. Results: Of 30,731 eligible patients, 4,766 received PMX. Propensity score matching produced a matched cohort of 4,141 pairs with well-balanced patient backgrounds. The 28-day survival rate was 77.9% in the PMX group and 71.1% in the control group (p < 0.0001). Median days of noradrenalin-, CHDF-, and ventilator-free days were 2 days (p < 0.0001), 2 days (p < 0.0001), and 6 days (p < 0.0001) longer in the PMX group than in the control group, respectively. When stratified with the maximum daily dose of noradrenaline, the PMX group showed a statistically significant survival benefit in the groups with noradrenaline dose <20 mg/day but not in the noradrenaline group dose ≥20 mg/day. Conclusion: Analysis of large Japanese databases showed that septic shock patients who received noradrenaline might benefit from PMX treatment.

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