一种新的脓毒性休克内毒素吸附剂：观察性病例系列。

A new endotoxin adsorber in septic shock: observational case series.

机构信息

Division of Intensive Care Medicine, Department of Anaesthesiology, Oulu University Hospital, Finland. tak @ cc.oulu.fi

出版信息

Blood Purif. 2011;32(4):303-9. doi: 10.1159/000330323. Epub 2011 Sep 2.

DOI:10.1159/000330323

PMID:21893976

Abstract

AIMS

Effects of a new endotoxin adsorber on the length of noradrenaline (NA) treatment, LPS (lipopolysaccharide) levels and SOFA (sequential organ failure assessment) scores in septic shock were evaluated.

METHODS

Two-hour hemoperfusion with LPS adsorber was initiated in patients with septic shock and endotoxemia. Controls were matched for age, focus and severity of illness.

RESULTS

Adsorption treatment (n = 9) exhibited a significant decrease in EAA (endotoxin activity assay) activity (0.55 [0.44-0.68] vs. 0.25 [0.13-0.41], p = 0.019) and NA infusion rate (0.217 μg/kg/min [0.119-0.0508] vs. 0 μg/kg/min [0-0.09], p = 0.026) from pretreatment to 24 h post-treatment. The median decrease in SOFA scores from pretreatment to 24 h was 3.0 points (1.5-4.5), p = 0.002. Duration of NA infusion was significantly shorter compared to controls (39 h [31-48] vs. 54 h [43-151], p = 0.03).

CONCLUSIONS

LPS adsorber treatment was associated with a decrease in NA dose, decrease in SOFA scores and LPS concentrations.

摘要

目的

评估新型内毒素吸附剂对内毒素血症性感染性休克患者去甲肾上腺素（NA）治疗时间、内毒素（LPS）水平和序贯器官衰竭评估（SOFA）评分的影响。

方法

对感染性休克伴内毒素血症患者进行 2 小时血液灌流吸附 LPS 治疗。对照组按年龄、感染部位和疾病严重程度进行匹配。

结果

吸附治疗组（n=9）的内毒素活性测定（EAA）活性（0.55 [0.44-0.68] 比 0.25 [0.13-0.41]，p=0.019）和 NA 输注率（0.217μg/kg/min [0.119-0.0508] 比 0μg/kg/min [0-0.09]，p=0.026）从治疗前到治疗后 24 小时均显著降低。治疗前至 24 小时 SOFA 评分的中位数下降 3.0 分（1.5-4.5），p=0.002。与对照组相比，NA 输注时间明显缩短（39 小时 [31-48] 比 54 小时 [43-151]，p=0.03）。