Department of Emergency and Acute Intensive Care Medicine, Fujita Health University, Toyoake, Aichi 470-1192, Japan.
Blood Purif. 2012;33(4):252-6. doi: 10.1159/000336341. Epub 2012 Mar 30.
We investigated whether early initiation of hemoperfusion with a polymyxin B cartridge (PMX) after the diagnosis of septic shock could improve the clinical outcome.
A prospective, open-labeled, multicenter cohort study was performed at intensive care units in Japan. 41 patients received PMX within 6 h after the diagnosis of septic shock (early group) and 51 patients were treated after 6 h (late group).
The early group had a significantly shorter duration of ventilator support and also had a lower catecholamine requirement. PMX was effective for improvement of hypotension, hypoperfusion, the sequential organ failure assessment score, and pulmonary oxygenation regardless of the timing of its initiation. The 28-day mortality rate did not differ between the two groups.
Early initiation of PMX shortened the duration of ventilator support and also reduced the catecholamine requirement, so early treatment of septic shock should achieve a better outcome.
我们研究了在感染性休克诊断后早期进行多粘菌素 B 柱（PMX）血液灌流是否能改善临床结局。
在日本的重症监护病房进行了一项前瞻性、开放标签、多中心队列研究。41 例患者在感染性休克诊断后 6 小时内接受 PMX（早期组），51 例患者在 6 小时后接受治疗（晚期组）。
早期组的呼吸机支持时间明显缩短，儿茶酚胺需求也较低。PMX 对改善低血压、低灌注、序贯器官衰竭评估评分和肺氧合均有效，与 PMX 开始的时间无关。两组 28 天死亡率无差异。
早期开始 PMX 可缩短呼吸机支持时间，并减少儿茶酚胺的需求，因此早期治疗感染性休克应能获得更好的结局。
