scholarly journals Eliminating endotoxin by polymyxin B hemoperfusion and/or continuous renal replacement therapy: should the focus be on timing, dosing, and type of renal epuration?

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Patrick M. Honore ◽  
David De Bels ◽  
Sebastien Redant ◽  
Herbert D. Spapen
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Polymyxin B ◽  
Polymyxin B Hemoperfusion

Potential Survival Benefit of Polymyxin B Hemoperfusion in Septic Shock Patients on Continuous Renal Replacement Therapy: A Propensity-Matched Analysis

2016 ◽  
Vol 42 (1) ◽  
pp. 9-17 ◽  
Author(s):  
Masao Iwagami ◽  
Hideo Yasunaga ◽  
Eisei Noiri ◽  
Hiromasa Horiguchi ◽  
Kiyohide Fushimi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Survival Benefit ◽  
Propensity Scores ◽  
Polymyxin B ◽  
Control Group ◽  
Diagnosis Procedure Combination ◽  
Polymyxin B Hemoperfusion

Background/Aims: We assessed the survival benefit of polymyxin B hemoperfusion (PMX) in septic shock patients starting continuous renal replacement therapy (CRRT), who are known to have an increased rate of mortality. Methods: Adult patients in the Japanese diagnosis procedure combination database satisfying the following criteria were enrolled: hospitalized in 2007-2012; diagnosed as having sepsis; required noradrenaline and/or dopamine; and started CRRT in intensive care unit. Propensity scores for receiving PMX were created from patient and hospital characteristics. Results: Of 3,759 eligible patients, 1,068 received PMX. Propensity-score matching produced a matched cohort of 978 pairs. The 28-day mortality was 40.2% (393/978) in the PMX group and 46.8% (458/978) in the control group (p = 0.003). Logistic regression analysis revealed a significant association between the use of PMX and decreased 28-day mortality (adjusted OR 0.75; 95% CI 0.62-0.91). Conclusion: This large retrospective study suggests that septic shock patients starting CRRT may benefit from PMX.

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