在术后感染性休克患者接受PMX-DHP治疗后，血清S100A12和sRAGE的变化与PaO(2)/FiO(2)比值的改善相关。

Changes in serum S100A12 and sRAGE associated with improvement of the PaO(2)/FiO(2) ratio following PMX-DHP therapy for postoperative septic shock.

作者信息

Takahashi G, Hoshikawa K, Matsumoto N, Shozushima T, Onodera C, Kan S, Akitomi S, Kikkawa T, Tomisawa Y, Kojika M, Sato N, Inoue Y, Suzuki K, Wakabayashi G, Endo S

机构信息

Department of Critical Care Medicine, Iwate Medical University, School of Medicine, Morioka, Japan.

出版信息

Eur Surg Res. 2011;47(3):135-40. doi: 10.1159/000330448. Epub 2011 Sep 13.

DOI:10.1159/000330448

PMID:21921634

Abstract

BACKGROUND

Endotoxin (Et) adsorption therapy with a column of polymyxin B-immobilized fibers (PMX) is effective in improving the partial pressure of arterial oxygen/fraction of inspired oxygen ratio (PaO(2)/FiO(2) ratio) and increasing mean arterial blood pressure (MAP) in sepsis. S100A12 and soluble receptor for advanced glycation end product (sRAGE) are useful as early markers of acute lung injury.

PURPOSE

To investigate the effect of improving the PaO(2)/FiO(2) ratio by PMX-direct hemoperfusion (PMX-DHP) on production of S100A12 and sRAGE.

SUBJECTS AND METHODS

Sepsis patients after surgery for perforation of the lower gastrointestinal tract were adopted as the subjects. We retrospectively reviewed the cases of 20 patients on mechanical ventilation and continuous administration of norepinephrine. We recorded PaO(2)/FiO(2) ratio, MAP, and norepinephrine doses. S100A12, sRAGE, and Et levels were measured before and after PMX-DHP.

RESULTS

The PaO(2)/FiO(2) ratio and MAP improved significantly after PMX-DHP (p < 0.05). S100A12 and Et decreased significantly after PMX-DHP (p < 0.05). No differences were observed in sRAGE.

CONCLUSION

S100A12 is useful as a marker that reflected improvement in the PaO(2)/FiO(2) ratio after PMX-DHP. We consider PMX-DHP to be useful as adjunctive therapy for sepsis that reduces the Et and corrects the pathology in the early stage.

摘要