Polymixin-B hemoperfusion in a case intolerant to conventional antibiotic therapy
- 1 Department “Paride Stefanini” General Surgery and Organs Transplant, Sapienza University, Rome, Italy
- 2 Department “Paride Stefanini” General Surgery and Organs Transplant, Sapienza University, Rome, Italy 2Department of
- 3 Department of Tropical and Infectous Disease, Sapienza University, Rome, Italy
- 4 Department of Clinical Engineering, Sapienza University, Rome, Italy
- 5 Department of Anesthesia and Intensive Care, Sapienza University, Rome, Italy 5Department of
- 6 Department of Gynecology and Obstretics, Sapienza University, Rome, Italy
- 7 Department of Gynecology and Obstretics, Sapienza University, Rome, Italy
- 8 Department of Gynecology and Obstretics, Sapienza University, Rome, Italy
Abstract
In this study we document how it was possible to resolve the septic complications of abdominal surgery, subjecting a patient severely allergic to intravenous antibiotics. We performed the hemoperfusion with polymyxin-B columns (PMX-DHP), guiding the therapy by assaying endotoxin activity and evaluating the clinical status of the patient after each session of PMX-DHP. The stabilization of hemodynamic and inflammatory frameworks were immediately observed after the PMX-DHP. The patient could be safely discharged five days after the discontinuation of the therapy. Our findings confirms data already published in literature concerning the effectiveness of PMX-DHP.
- Tani, T., Shoji, H., Guadagni, G. and Perego, A. (2010) Extracorporeal removal of endotoxin: The polymyxin B-immobilized fiber cartridge. Contributions to Nephrology, 167, 35-44. doi:10.1159/000315917
- Cruz, D.N., Perazella, M.A., Bellomo, R., et al. (2007) Effectiveness of polymyxin B-immobilized fiber column in sepsis: A systematic review. Critical Care, 11, R47. doi:10.1186/cc5780
- Cantaluppi, V., Assenzio, B., Pasero, D., et al. (2008) Polymyxin-B hemoperfusion inactivates circulating proapoptotic factors. Intensive Care Medicine, 34, 1638-1645. doi:10.1007/s00134-008-1124-6
- Shoji, H. (2003) Extracorporeal endotoxin removal for the treatment of sepsis: Endotoxin adsorption cartridge (Toraymyxin). Therapeutic Apheresis and Dialysis, 7, 108-114. doi:10.1046/j.1526-0968.2003.00005.x
- Shimizu, T., Yoshihiro, E., Tsuchihashi, H., et al. (2006) Endotoxin apheresis for sepsis. Transfusion and Apheresis Science, 35, 271-282. doi:10.1016/j.transci.2006.06.006
- Marshall, J.C., Foster, D., Vincent, J.L., et al. (2004) Diagnostic and prognostic implications of endotoxemia in critical illness: Results of the MEDIC study. Journal of Infectious Diseases, 190, 527-534. doi:10.1086/422254
- Monti, G., Bottiroli, M., Pizzilli, G., et al. (2010) Endotoxin activity level and septic shock: A possible role for specific anti-endotoxin therapy? Contributions to Nephrology, 167, 102-110. doi:10.1159/000315924
- Novelli, G., Ferretti, G., Ruberto, F., et al. (2010) Early management of endotoxemia using the endotoxin activity assay and polymyxin B-based hemoperfusion. Contributions to Nephrology, 167, 91-101. doi:10.1159/000315923
- Romaschin, A.D., Harris, D.M., Ribeiro, M.B., et al. (1998) A rapid assay of endotoxin in whole blood using autologous neutrophil-dependent chemiluminescence. Journal of Immunological Methods, 212, 16-85. doi:10.1016/S0022-1759(98)00003-9
- Hanasawa, K., Tani, T. and Kodama, M. (1989) New approach to endotoxic and septic shock by means of polymyxin B immobilized fiber. Surgery Gynecology & Obstetrics, 168, 323-331.
- Shoji, H., Tani, T., Hanasawa, K. and Kodama, M. (1998) Extracorporeal endotoxin removal by polymyxin B immobilized fiber cartridge: Designing and antiendotoxin efficacy in the clinical application. Therapeutic Apheresis, 2, 3-12. doi:10.1111/j.1744-9987.1998.tb00066.x