Evidence map›Paper›PMID 28358803›Full record

Trial reportPloS one2017

Efficacy of polymyxin B-immobilized fiber hemoperfusion for patients with septic shock caused by Gram-negative bacillus infection.

Nobuyuki Saito, Kazuhiro Sugiyama, Testu Ohnuma, Takashi Kanemura, Michitaka Nasu, Yuya Yoshidomi, Yuta Tsujimoto, Hiroshi Adachi, Hiroyuki Koami, Aito Tochiki and 3 more

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 12 institutions in 1 country.

Nobuyuki SaitoShock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.
Kazuhiro SugiyamaDepartment of Emergency and Critical Care Medicine, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Testu OhnumaIntensive Care Unit, Department of Anesthesiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Takashi KanemuraDepartment of Emergency and Critical Care Medicine, National Disaster Medical Center, Tokyo, Japan.
Michitaka NasuDepartment of Emergency and Critical Care Medicine, Urasoe General Hospital, Okinawa, Japan.
Yuya YoshidomiDepartment of Emergency Medicine, Saga-Ken Medical Center Koseikan, Saga, Japan.
Yuta TsujimotoDepartment of Emergency Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan.
Hiroshi AdachiDepartment Intensive Care Medicine, Iizuka Hospital, Fukuoka, Japan.
Hiroyuki KoamiAdvanced Emergency Care Center, Saga University Hospital, Saga, Japan.
Aito TochikiDepartment of Emergency and Critical Care Medicine, Tsukuba Medical Center Hospital, Ibaraki, Japan.
Kota HoriDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Yukiko WagatsumaFaculty of Medicine, Department of Clinical Trial and Clinical Epidemiology, University of Tsukuba, Ibaraki, Japan.
Hisashi MatsumotoShock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.
Chiba Hokusou Hospital · JPAso Iizuka Hospital · JPJapanese Red Cross Kumamoto Hospital · JPJichi Medical University Saitama Medical Center · JPNational Disaster Medical Center · JPSaga-Ken Medical Centre Koseikan · JPSaga University · JPTokyo Metropolitan Bokutoh Hospital · JPTsukuba Medical Center Hospital · JPUniversity of Tsukuba · JPUrasoe General HospitalYamagata Prefectural Central Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Septic shock-associated mortality in intensive care units (ICUs) remains high, with reported rates ranging 30-50%. In particular, Gram-negative bacilli (GNB), which induce significant inflammation and consequent multiple organ failure, are the etiological bacterial agent in 40% of severe sepsis cases. Hemoperfusion using polymyxin B-immobilized fiber (PMX), which adsorbs endotoxin, is expected to reduce the inflammatory sepsis cascade due to GNB. However, the clinical efficacy of this treatment has not yet been demonstrated. Here, we aimed to verify the efficacy of endotoxin adsorption therapy using PMX through a retrospective analysis of 413 patients who received broad spectrum antimicrobial treatment for GNB-related septic shock between January 2009 and December 2012 in 11 ICUs of Japanese tertiary hospitals. After aligning the patients' treatment time phases, we classified patients in two groups depending on whether PMX hemoperfusion (PMXHP) therapy was administered or not within 24 hours after ICU admission (PMXHP group: n = 134, conventional group: n = 279). The primary study endpoint was the mortality rate at 28 days after ICU admission. The mean age was 72.4 (standard deviation: 12.6) years, and the mean Sequential Organ Failure Assessment score at ICU admission was 9.9 (3.4). The infection sites included intra-abdominal (38.0%), pulmonary (18.9%), and urinary tract (32.2%), and two thirds of all patients had GNB-related bacteremia. Notably, the mortality at 28 days after ICU admission did not differ between the groups (PMXHP: 29.1% vs. conventional: 29.0%, P = 0.98), and PMXHP therapy was not found to improve this outcome in a Cox regression analysis (hazard ratio = 1.16; 95% confidence interval, 0.81-1.64, P = 0.407). We conclude that PMX-based endotoxin adsorption within 24 hours from ICU admission was not associated with mortality among patients with septic shock due to GNB.

trial registrationUniversity Hospital Medical Information Network Clinical Trial Registry (UMIN-CTR ID: UMIN000012748).

Indexed as

AgedAged, 80 and overEndotoxinsFemaleGram-Negative BacteriaGram-Negative Bacterial InfectionsHemoperfusionHumansIntensive Care UnitsJapanMaleMortalityPolymyxin BRespiratory Tract InfectionsShock, SepticEndotoxinsPolymyxin B

Identifiers

PMID28358803
PMCPMC5373513
OpenAlexW2599142020

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.