Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
Laboratory for Immune Response and Regulatory Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
Blood Purif. 2018;46(4):269-273. doi: 10.1159/000489920. Epub 2018 Jul 3.
Polymyxin B-immobilized fiber (PMX-F) columns are used as therapeutic interventions for septic shock. The clinical efficacy has been reported for 2-h applications, but their ability to adsorb endotoxin over longer treatments has not been fully elucidated. We hypothesized that PMX-F columns are capable of endotoxin removal for more than 2 h.
We designed closed circuits incorporating either a PMX-F column with an 8.5-mL priming volume (PMX-01R) or a sham-control column, and used inactivated fetal bovine serum as the circulating perfusate. Endotoxin was continuously injected at a fixed rate for 24 h, and perfusate endotoxin concentrations were measured at fixed time points. PMX-01R endotoxin adsorption was calculated from the difference in the endotoxin concentrations.
PMX-01R endotoxin adsorption increased continuously in a virtually linear manner.
The PMX-01R column showed sustained endotoxin adsorption for at least 24 h. This indicated that PMX-F columns would be capable of clinical endotoxin removal for 24 h.
多粘菌素 B 固定纤维（PMX-F）柱被用作治疗感染性休克的干预措施。已有关于 2 小时应用的临床疗效报告，但它们在更长时间的治疗中吸附内毒素的能力尚未完全阐明。我们假设 PMX-F 柱能够在超过 2 小时的时间内去除内毒素。
我们设计了闭合回路，其中包含一个带有 8.5 毫升预充体积的 PMX-F 柱（PMX-01R）或假对照柱，并使用灭活胎牛血清作为循环灌流液。以内毒素以固定速率连续注射 24 小时，并在固定时间点测量灌流液内毒素浓度。PMX-01R 内毒素吸附通过内毒素浓度的差异计算得出。
PMX-01R 对内毒素的吸附呈连续且近乎线性增加。
PMX-01R 柱至少在 24 小时内显示出持续的内毒素吸附能力。这表明 PMX-F 柱能够在 24 小时内进行临床内毒素清除。
