Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial.
Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial.
复制标题
DOI：
10.1007/s00134-015-3751-z
复制
发表时间：
2015-06
影响因子：
38.9
通讯作者：
Robert, Rene
中科院分区：
文献类型：
--
作者：
Payen, Didier M.;Guilhot, Joelle;Launey, Yoann;Lukaszewicz, Anne Claire;Kaaki, Mahmoud;Veber, Benoit;Pottecher, Julien;Joannes-Boyau, Olivier;Martin-Lefevre, Laurent;Jabaudon, Matthieu;Mimoz, Olivier;Coudroy, Remi;Ferrandiere, Martine;Kipnis, Eric;Vela, Carlos;Chevallier, Stephanie;Mallat, Jihad;Robert, Rene
检测多粘菌素B血液灌流（PMX HP）纤维柱是否可降低腹腔感染引起的腹膜炎诱导的脓毒性休克（SS）的死亡率和器官衰竭。2010年10月至2013年3月在18个法国重症监护室进行的前瞻性、多中心、随机对照试验，入组了243例因器官穿孔相关腹膜炎接受急诊手术后12小时内发生SS的患者。PMX HP组接受常规治疗加两次PMX HP治疗。主要结局是第28天的死亡率;次要结局是第90天的死亡率以及基于序贯器官衰竭评估（SOFA）评分的器官衰竭严重程度的降低。主要结局：PMX HP组（n = 119）第28天的死亡率为27.7%，而常规组（n = 113）为19.5%，p = 0.14（OR 1.5872，95%CI 0.8583-2.935）。次要终点：PMX-HP组第90天的死亡率为33.6%，而常规组为24%，p = 0.10（OR 1.6128，95% CI 0.9067-2.8685）; PMX-HP组第0天至第7天的SOFA评分降低为-5（-11至6），而常规组为-5（-11至9），p = 0.78。在预定义的亚组（存在合并症;手术充分性，<2次血液灌流）和第0天至第3天的SOFA降低中观察到相当的结果。这项多中心随机对照研究表明，与腹膜炎诱导的SS的常规治疗相比，PMX HP治疗的死亡率无显著增加，器官衰竭无改善。本文的在线版本（doi：10.1007/s 00134 -015-3751-z）包含补充材料，可供授权用户使用。
To test whether the polymyxin B hemoperfusion (PMX HP) fiber column reduces mortality and organ failure in peritonitis-induced septic shock (SS) from abdominal infections. Prospective, multicenter, randomized controlled trial in 18 French intensive care units from October 2010 to March 2013, enrolling 243 patients with SS within 12 h after emergency surgery for peritonitis related to organ perforation. The PMX HP group received conventional therapy plus two sessions of PMX HP. Primary outcome was mortality on day 28; secondary outcomes were mortality on day 90 and a reduction in the severity of organ failures based on Sequential Organ Failure Assessment (SOFA) scores. Primary outcome: day 28 mortality in the PMX HP group (n = 119) was 27.7 versus 19.5 % in the conventional group (n = 113), p = 0.14 (OR 1.5872, 95 % CI 0.8583–2.935). Secondary endpoints: mortality rate at day 90 was 33.6 % in PMX-HP versus 24 % in conventional groups, p = 0.10 (OR 1.6128, 95 % CI 0.9067–2.8685); reduction in SOFA score from day 0 to day 7 was −5 (−11 to 6) in PMX-HP versus −5 (−11 to 9), p = 0.78. Comparable results were observed in the predefined subgroups (presence of comorbidity; adequacy of surgery, <2 sessions of hemoperfusion) and for SOFA reduction from day 0 to day 3. This multicenter randomized controlled study demonstrated a non-significant increase in mortality and no improvement in organ failure with PMX HP treatment compared to conventional treatment of peritonitis-induced SS. The online version of this article (doi:10.1007/s00134-015-3751-z) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
3
作者：
Nemoto, H;Nakamoto, H;Suzuki, H
通讯作者：
Suzuki, H
影响因子：
3.1
作者：
Vincent, JL;Laterre, PF;John, S
通讯作者：
John, S
影响因子：
158.5
作者：
Ranieri, V. Marco;Thompson, B. Taylor;Williams, Mark D.
通讯作者：
Williams, Mark D.
影响因子：
38.9
作者：
Joannes-Boyau, Olivier;Honore, Patrick M.;Ouattara, Alexandre
通讯作者：
Ouattara, Alexandre
影响因子：
64.8
作者：
Calvano, SE;Xiao, WZ;Lowry, SF
通讯作者：
Lowry, SF