A LONGER DURATION OF POLYMYXIN B-IMMOBILIZED FIBER COLUMN HEMOPERFUSION IMPROVES PULMONARY OXYGENATION IN PATIENTS WITH SEPTIC SHOCK
A LONGER DURATION OF POLYMYXIN B-IMMOBILIZED FIBER COLUMN HEMOPERFUSION IMPROVES PULMONARY OXYGENATION IN PATIENTS WITH SEPTIC SHOCK
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DOI：
10.1097/shk.0b013e3181a2a978
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发表时间：
2009-11-01
期刊：
影响因子：
3.1
通讯作者：
Sasaki, Sei
中科院分区：
文献类型：
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作者：
Mitaka, Chieko;Tsuchida, Naoki;Sasaki, Sei
内毒素在感染性休克的发病中起重要作用。内皮细胞暴露于内毒素激活内皮细胞并增加粘附分子的表面表达，粘附分子是器官功能障碍中内皮损伤的标志物。多粘菌素B固定化纤维柱（PMX）血液灌流内毒素吸附治疗已用于治疗感染性休克患者。本研究通过检测脓毒性休克患者在PMX治疗前后血浆内毒素和可溶性粘附分子的浓度，观察实际使用时间与各种结局的关系。对16例感染性休克患者进行了研究。28天死亡率为50%。PMX治疗后，存活者血浆内毒素浓度升高，但死亡者血浆内毒素浓度升高。去甲肾上腺素剂量和血浆可溶性内皮细胞白细胞粘附分子1和可溶性细胞间粘附分子1浓度显著升高（P
Endotoxin plays an important role in the pathogenesis of septic shock. Exposure of endothelial cells to endotoxin activates endothelial cells and increases the surface expression of adhesion molecules, markers of endothelial damage in organ dysfunction. Endotoxin adsorption therapy by polymyxin B-immobilized fiber column (PMX) hemoperfusion has been used for the treatment of septic shock patients. In this study, we measured plasma concentrations of endotoxin and soluble adhesion molecules in septic shock patients before and after the PMX treatment then observed on the relationships between actual duration of use and various outcomes. Sixteen patients with septic shock were studied. The 28-day mortality rate was 50%. The elevated plasma concentrations of endotoxin decreased after the PMX treatment in the survivors but not in the nonsurvivors. The norepinephrine dose and plasma concentrations of soluble endothelial leukocyte adhesion molecule 1 and soluble intercellular adhesion molecule 1 significantly (P