Continuous Hemodiafiltration with a Cytokine-Adsorbing Hemofilter in Patients with Septic Shock: A Preliminary Report

2014 ◽  
Vol 38 (3-4) ◽  
pp. 211-218 ◽  
Author(s):  
Hidetoshi Shiga ◽  
Hiroyuki Hirasawa ◽  
Osamu Nishida ◽  
Shigeto Oda ◽  
Masataka Nakamura ◽  
...  
Keyword(s):  
Septic Shock ◽  
Preliminary Report ◽  
Continuous Hemodiafiltration

scholarly journals Effects of Polymyxin B Hemoperfusion on Septic Shock Patients Requiring Noradrenaline: Analysis of a Nationwide Administrative Database in Japan

2021 ◽  
pp. 1-6
Author(s):  
Kenji Fujimori ◽  
Kunio Tarasawa ◽  
Kiyohide Fushimi
Keyword(s):  
Septic Shock ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Polymyxin B ◽  
Administrative Database ◽  
Control Group ◽  
Continuous Hemodiafiltration ◽  
Significant Survival ◽  
Maximum Daily Dose ◽  
Polymyxin B Hemoperfusion

<b><i>Introduction:</i></b> Polymyxin B hemoperfusion (PMX) reduces endotoxin in septic shock patients’ blood and can improve hemodynamics and organ functions. However, its effects on the reduction of septic shock mortality are controversial. <b><i>Methods:</i></b> Using the Japanese diagnosis procedure combination database from April 2016 to March 2019, we identified adult septic shock patients treated with noradrenaline. This study used propensity score matching to compare the outcome between PMX-treated and non-treated patients. The primary endpoint was 28-day mortality, counting from the day of noradrenaline initiation. The secondary endpoints were noradrenaline-, ventilator-, and continuous hemodiafiltration (CHDF)-free days at day 28. <b><i>Results:</i></b> Of 30,731 eligible patients, 4,766 received PMX. Propensity score matching produced a matched cohort of 4,141 pairs with well-balanced patient backgrounds. The 28-day survival rate was 77.9% in the PMX group and 71.1% in the control group (<i>p</i> &#x3c; 0.0001). Median days of noradrenalin-, CHDF-, and ventilator-free days were 2 days (<i>p</i> &#x3c; 0.0001), 2 days (<i>p</i> &#x3c; 0.0001), and 6 days (<i>p</i> &#x3c; 0.0001) longer in the PMX group than in the control group, respectively. When stratified with the maximum daily dose of noradrenaline, the PMX group showed a statistically significant survival benefit in the groups with noradrenaline dose &#x3c;20 mg/day but not in the noradrenaline group dose ≥20 mg/day. <b><i>Conclusion:</i></b> Analysis of large Japanese databases showed that septic shock patients who received noradrenaline might benefit from PMX treatment.

scholarly journals Continuous Hemodiafiltration with PMMA Hemofilter in the Treatment of Patients with Septic Shock

2008 ◽  
Vol 14 (5-6) ◽  
pp. 257-263 ◽  
Author(s):  
Taka-aki Nakada ◽  
Shigeto Oda ◽  
Ken-ichi Matsuda ◽  
Tomohito Sadahiro ◽  
Masataka Nakamura ◽  
...  
Keyword(s):  
Septic Shock ◽  
Continuous Hemodiafiltration

Evaluation of plasma levels of meropenem in septic patients during extracorporeal blood purification

2021 ◽  
Vol 20 (4) ◽  
pp. 81-94
Author(s):  
Artem V. Marukhov ◽  
Elena V. Murzina ◽  
Mikhail V. Zakharov ◽  
Genrikh A. Sofronov ◽  
Lyudmila V. Buryakova ◽  
...  
Keyword(s):  
Septic Shock ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Selective Adsorption ◽  
Plasma Concentrations ◽  
Blood Purification ◽  
Continuous Hemodiafiltration ◽  
Extracorporeal Blood ◽  
Extracorporeal Blood Purification ◽  
Extracorporeal Support

The relevance. Meropenem is a broad-spectrum carbapenem antibiotic widely used to treat patients with sepsis / septic shock. Critically ill patients are usually supported with one of the forms extracorporeal blood purification. However, data on the effect of various extracorporeal support techniques on the pharmacokinetics and pharmacodynamics of meropenem are insufficient or contradictory. Aim: To evaluate the effectiveness of meropenem dosage regimens in the treatment of septic patients during extracorporeal blood purification. Materials and methods. Plasma concentrations of meropenem were monitored in three critically ill patients with sepsis or septic shock. Patients were treated using various extracorporeal support techniques. Meropenem was used as empirical antibacterial mono- or complex therapy (1 g every 8 or 12 hours). Meropenem concentrations in plasma were determined by validated assay methods on Acquity ultraefficient liquid chromatography (UPLC) H-Class system. Results. It is shown that the meropenem plasma concentration in critically ill patients changes significantly. It was found that the standard meropenem dosing regimens in patients with sepsis / septic shock during continuous hemodiafiltration do not ensure the achievement of the PK/PD target of 100% TMIC for sensitive strains (MIC2 mg/L) and for intermediate resistance pathogens (2MIC8 mg/L). Continuous hemofiltration and selective adsorption of lipopolysaccharide have a less pronounced effect on the clearance of meropenem. Conclusion. To increase the effectiveness of antibacterial therapy, it is necessary to conduct research aimed at developing protocols for dosing antibacterial drugs for the treatment of sepsis during extracorporeal blood purification.

LIMITATION OF OXYGEN DELIVERY SUPRA-NORMALIZATION THERAPY (ODST) AND EFFICACY OF CONTINUOUS HEMODIAFILTRATION (CHDF) IN TREATMENT OF DYSOXIA IN SEPTIC SHOCK.

Shock ◽  
1999 ◽  
Vol 12 (Supplement) ◽  
pp. 33-34
Author(s):  
T. Sadahiro ◽  
H. Hirasawa ◽  
T. Sugai ◽  
S Oda ◽  
H Shiga ◽  
...  
Keyword(s):  
Septic Shock ◽  
Oxygen Delivery ◽  
Continuous Hemodiafiltration

scholarly journals Korean Shock Society septic shock registry: a preliminary report

2017 ◽  
Vol 4 (3) ◽  
pp. 146-153 ◽  
Author(s):  
Tae Gun Shin ◽  
Sung Yeon Hwang ◽  
Gu Hyun Kang ◽  
Won Young Kim ◽  
Seung Mok Ryoo ◽  
...  
Keyword(s):  
Septic Shock ◽  
Preliminary Report

Effectiveness of Continuous Hemodiafiltration Using a Polymethylmethacrylate Membrane Hemofilter After Polymyxin B-Immobilized Fiber Column Therapy of Septic Shock

ASAIO Journal ◽  
2008 ◽  
Vol 54 (1) ◽  
pp. 129-132 ◽  
Author(s):  
Yuichiro Sakamoto ◽  
Kunihiro Mashiko ◽  
Toru Obata ◽  
Hisashi Matsumoto ◽  
Yoshiaki Hara ◽  
...  
Keyword(s):  
Septic Shock ◽  
Polymyxin B ◽  
Continuous Hemodiafiltration
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