Original Paper

Newly Developed Immobilized Polymyxin B Fibers Improve the Survival of Patients with Sepsis
Hironori Nemoto, Hidetomo Nakamoto, Hirokazu Okada, Souichi Sugahara, Kenshi Moriwaki, Mitsuru Arai, Yoshihiko Kanno, Hiromichi Suzuki

Department of Nephrology and Kidney Disease Center, Saitama Medical College, Saitama, Japan

Address of Corresponding Author

Blood Purif 2001;19:361-369 (DOI: 10.1159/000046966)

  Key Words

• Septic shock
• Endotoxin
• Hemoperfusion
• Randomized clinical trial

  Abstract

Background: Sepsis and septic shock are still major causes of morbidity and mortality in spite of the availability of powerful and broadly active antibiotics. Methods: A prospective, open and randomized trial of the effect of immobilized polymyxin fibers (PMX-F) on the survival of patients with sepsis throughout a follow-up period of 28 days or until discharge, if earlier, was carried out. Ninety-eight patients were included who met at least 4 of the criteria for systemic inflammatory response syndrome due to infection. The patients were classified into three groups based on their Acute Physiology and Chronic Health Evaluation (APACHE) II score. Results: The overall survival rate was significantly improved by using PMX-F compared to the control group (41 vs. 11%) (p = 0.002). In patients with an APACHE II score less than 20, treatment with PMX-F was shown to improve outcome (65 vs. 19%) (p = 0.01). In cases of more severe sepsis with an APACHE II score of 20-29, PMX-F still maintained efficacy in improving outcome (40 vs. 11%) (p = 0.04). However, PMX-F treatment did not improve the survival rate in patients with an APACHE II score of greater than 30 (survival rate 7 vs. 0%) (p = 0.59). Conclusion: From these results, it is concluded that treatment with PMX-F in patients with sepsis is effective and prolongs the survival rate when applied at an early stage of sepsis. However, in severe sepsis, this therapy does not improve the survival rate.

Copyright © 2001 S. Karger AG, Basel

  Author Contacts

Hiromichi Suzuki, MD
Department of Nephrology and Kidney Disease Center, Saitama Medical College
Moroyama-machi, Iruma-gun, Saitama Prefecture 390-0495 (Japan)
Tel. +81 492 76 1611, Fax +81 492 95 7338, E-Mail iromichi@saitama-med.ac.jp

  Article Information

Received: Accepted: January 10, 2001
Number of Print Pages : 9
Number of Figures : 4, Number of Tables : 4, Number of References : 35