Modifications of peripheral perfusion in patients with vasopressor-dependent septic shock treated with polymyxin B-direct hemoperfusion.
Modifications of peripheral perfusion in patients with vasopressor-dependent septic shock treated with polymyxin B-direct hemoperfusion.
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DOI：
10.1038/s41598-023-34084-0
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发表时间：
2023-05-05
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
作者：
外周血灌注异常（PP）是影响感染性休克患者预后的重要因素。多粘菌素B直接血液灌流（PMX-DHP）可升高血压并减少血管加压药剂量。然而，在血管加压素依赖性脓毒性休克患者中，PMX-DHP给药后PP的变化尚未阐明。在接受PMX-DHP治疗的感染性休克患者中进行了一项回顾性探索性观察性研究。在PMX-DHP开始（T0）以及24（T24）和48（T48）h后提取脉搏幅度指数（派）、血管活性变力性评分（维斯）和累积液体平衡数据。根据PMX-DHP启动时的派，分析所有患者和两个亚组（PP异常[派< 1]和PP正常[派≥ 1]）中这些数据的变化。总体而言，对122例患者（PP异常组，n = 67; PP正常组，n = 55）进行了评价。总体及PP异常组T24、T48时派较T0时显著升高，维斯较T0时显著降低。在异常PP组中，PMX-DHP开始后累积24小时液体平衡显著更高。PMX-DHP可能是改善PP异常患者PP的有效干预措施;但是，应谨慎，因为液体需求可能与PP正常患者不同。
Abnormal peripheral perfusion (PP) worsens the prognosis of patients with septic shock. Polymyxin B-direct hemoperfusion (PMX-DHP) increases blood pressure and reduces vasopressor doses. However, the modification of PP following administration of PMX-DHP in patients with vasopressor-dependent septic shock have not yet been elucidated. A retrospective exploratory observational study was conducted in patients with septic shock treated with PMX-DHP. Pulse-amplitude index (PAI), vasoactive inotropic score (VIS), and cumulative fluid balance data were extracted at PMX-DHP initiation (T0) and after 24 (T24) and 48 (T48) h. Changes in these data were analyzed in all patients and two subgroups (abnormal PP [PAI < 1] and normal PP [PAI ≥ 1]) based on the PAI at PMX-DHP initiation. Overall, 122 patients (abnormal PP group, n = 67; normal PP group, n = 55) were evaluated. Overall and in the abnormal PP group, PAI increased significantly at T24 and T48 compared with that at T0, with a significant decrease in VIS. Cumulative 24-h fluid balance after PMX-DHP initiation was significantly higher in the abnormal PP group. PMX-DHP may be an effective intervention to improve PP in patients with abnormal PP; however, caution should be exercised as fluid requirements may differ from that of patients with normal PP.
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影响因子：
2.2
作者：
Yokoyama H;Sekino M;Funaoka H;Sato S;Araki H;Egashira T;Yano R;Matsumoto S;Ichinomiya T;Higashijima U;Hara T
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15.1
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影响因子：
3.3
作者：
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通讯作者：
Bulkley, Gregory B
影响因子：
7.5
作者：
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通讯作者：
Shimazaki, Shuji