Effects of prolonged direct hemoperfusion using a polymyxin B immobilized fiber cartridge on interleukin-6 concentration in patients with septic shock: A prospective exploratory trial

Kyohei Miyamoto, Yu Kawazoe, Shigeo Negi, Naoaki Shibata, Atsuhiro Ogawa, Nozomu Shima, Kosei Kunitatsu, Yukihiro Shima, Nobuko Yamamoto, Masahiro Kaneko, Maki Kida, Masaou Tanaka, Masaki Ohya, Takashi Shigematsu, Seiya Kato

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: The aim of this study was to evaluate the effect of prolonged direct hemoperfusion using polymyxin B immobilized fiber cartridges (PMX-DHP) on interleukin-6 (IL-6) concentration in patients with septic shock. Methods: A total of 16 patients received a total of 26 sessions of 12-h PMX-DHP (PMX-DHP-12h group) and 7 patients received a total of 11 sessions of 2-h PMX-DHP (PMX-DHP-2h group). We compared serum IL-6 concentrations and other secondary outcomes between the two treatment groups. IL-6 concentrations were measured at 0, 2, 5, 8, and 12 h. Results: The median age was 78 years (interquartile range [IQR] 60-84) in PMX-DHP-12h group and 75 years (IQR 66-81) in PMX-DHP-2h group (P = 0.92). The median acute physiology and chronic health evaluation II score was 23 (IQR 18-31) in the PMX-DHP-12h group and 21 (IQR 17-28) in the PMX-DHP-2h group (P = 0.64). A major source of infection in both groups was the abdomen. The serum IL-6 concentrations in both groups significantly decreased at each time point after 0 h (P < 0.05). However, the decrease in IL-6 concentration did not differ between the groups (P = 0.92). In-hospital mortality was not significantly different in the PMX-DHP-12h group vs. PMX-DHP-2h group (7 patients [44%] vs. 1 patient [14%]; P = 0.35). Conclusions: We could not confirm the additional effect that 12 h of PMX-DHP had on the reduction in serum IL-6 concentrations over that exerted by 2 h of this regimen. Trial registration: UMIN-CTR, UMIN000016654. Registered 3 March 2015

Original languageEnglish
Article number20
JournalRenal Replacement Therapy
Volume5
Issue number1
DOIs
Publication statusPublished - 2019 May 14
Externally publishedYes

Keywords

  • Interleukin-6
  • PMX-DHP
  • Septic shock

ASJC Scopus subject areas

  • Urology
  • Transplantation
  • Nephrology

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