Effect of polymyxin B-immobilized fiber hemoperfusion on respiratory impairment, hepatocellular dysfunction, and leucopenia in a neonatal sepsis model
Effect of polymyxin B-immobilized fiber hemoperfusion on respiratory impairment, hepatocellular dysfunction, and leucopenia in a neonatal sepsis model
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DOI：
10.1007/s00383-009-2476-x
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发表时间：
2010-02-01
影响因子：
1.8
通讯作者：
Togari, Hajime
中科院分区：
文献类型：
--
作者：
Hussein, Mohamed Hamed;Daoud, Ghada A.;Togari, Hajime
尽管在抗微生物药物和积极的支持性护理方面取得了进展，但败血症和感染性休克仍然是新生儿发病率和死亡率的主要来源。我们的目的是研究多粘菌素- b直接血液灌流（PMX-DHP）治疗对新生儿盲肠结扎穿孔（CLP）模型脓毒症引起的呼吸障碍、肝功能障碍和白细胞减少的影响。14头麻醉和机械通气的3日龄仔猪在CLP后3小时至6小时进行CLP和动静脉体外循环，PMX- dhp治疗组（7头仔猪）采用PMX柱。测定血氧饱和度、PCO(2)、碱性过剩、白细胞（WBC）计数、血小板计数、血细胞比容（Hct%）、血清谷氨酸丙酮酸转氨酶（SGPT）、血清谷草酰乙酸转氨酶在CLP前及CLP后1、3、6 h的变化。6 h时，PMX-DHP组的Hct%和SGPT较对照组低，但氧饱和度和白细胞计数较高。未发现对血小板计数有影响。PMX-DHP组小鼠存活时间明显长于对照组。PMX-DHP治疗限制了新生儿脓毒症模型的呼吸障碍、肝功能障碍和白细胞减少，从而提高了生存时间。
Sepsis and septic shock remain a major source of morbidity and mortality in neonates despite advances in antimicrobials and aggressive supportive care. Our aim was to study the effects of polymyxin-B direct hemoperfusion (PMX-DHP) therapy on sepsis-induced respiratory impairment, liver dysfunction and leucopenia in a neonatal cecal ligation and perforation (CLP) model.Fourteen anesthetized and mechanically ventilated 3-day-old piglets underwent CLP and an arteriovenous extracorporeal circuit from 3 h until 6 h post-CLP, with a PMX column in the PMX-DHP treated group (7 piglets). Changes in oxygen saturation, PCO(2), base excess, white blood cell (WBC) count, platelet count, hematocrit (Hct%), serum glutamate pyruvate transaminase (SGPT), and serum glutamic oxaloacetic transaminase were measured before CLP and at 1, 3 and 6 h after.At 6 h, the PMX-DHP group showed lower Hct%, and SGPT in comparison to the control group, but higher oxygen saturation and WBC count. No effects on the platelet count were found. The survival times of the PMX-DHP group were longer than in control.PMX-DHP therapy limited the respiratory impairment, liver dysfunction and leucopenia in a neonatal septic model, which resulted in an improvement of survival time.