ArticleAnnals of intensive care2018
Impact of hemoperfusion with polymyxin B added to hemofiltration in patients with endotoxic shock: a case-control study.
Article in Annals of intensive care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 16 citations in OpenAlex.
- Clinical applications for the endotoxin activity assay in sepsis: a scoping review.Critical care (London, England) · 2026Article
- Comparative efficacy of two hemopurification filters for treating intra-abdominal sepsis: A retrospective study.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Incorporation of oXiris Bioabsorbent Filter into CRRT in the treatment of severe abdominal infections and analysis of associated risk factors for early off-machine.Frontiers in public health · 2025Article
- High adsorption capacity of hemoperfusion on imipenem in critically ill patients with septic shock: a case report.BMC infectious diseases · 2024Article
- Article
- Potential survival benefit and early recovery from organ dysfunction with polymyxin B hemoperfusion: perspectives from a real-world big data analysis and the supporting mechanisms of action.Journal of anesthesia, analgesia and critical care · 2022Review
- Efficacy of Oxymatrine Plus Antiviral in the Treatment of Sepsis and Its Effect on the Levels of Endotoxin and Inflammatory Factors.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Surviving Sepsis Campaign: Research Opportunities for Infection and Blood Purification Therapies.Critical care explorations · 2021Review
- Extracorporeal Hemoperfusion as a Potential Therapeutic Option for Severe COVID-19 patients; a Narrative Review.Archives of academic emergency medicine · 2020Review
- Eliminating endotoxin by polymyxin B hemoperfusion and/or continuous renal replacement therapy: should the focus be on timing, dosing, and type of renal epuration?Annals of intensive care · 2019Article
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeptic shock is a leading cause of death in critical patients. In patients with gram-negative septic shock, hemoperfusion with polymyxin B aims to remove endotoxins from plasma. We analyzed the clinical and biological response to hemoperfusion in patients with septic shock and acute kidney injury.
methodsThis prospective case-control study in the medical-surgical intensive care unit of a university hospital included consecutive adults patients with septic shock and suspected gram-negative bacteria infection with elevated plasma endotoxin activity (EAA > 0.6 EU/ml) and acute kidney injury requiring continuous renal replacement therapy (CRRT). At onset of septic shock, half underwent CRRT plus hemoperfusion with polymyxin B for two hours a day during two consecutive days (hemoperfusion group) and half received only CRRT (control group). We measured clinical, physiological, and biological parameters (EAA, C-reactive protein, procalcitonin, and cytokines) daily during the first 5 days.
resultsWe included 18 patients (male, 33%; mean age, 67.5; mean SOFA score, 11.3). Abdominal infections predominated (50% had peritonitis). At the beginning of CRRT, RIFLE classification was "failure" for 72% and "injury" for 28%. Baseline characteristics did not differ between groups. Patients in the hemoperfusion group required longer mechanical ventilation (12.4 vs. 9.4 days, p = 0.03) and CRRT (8.5 vs. 6 days, p = 0.01) than in the control group. Noradrenaline doses, lactate, procalcitonin, and C-reactive protein decreased in both groups. At day 5, EAA was significantly lower in the hemoperfusion group (0.58 EU/ml vs. 0.73 EU/ml in controls, p = 0.03). There were no significant differences between groups in other biomarkers or ICU mortality (33.3% in the treatment group vs. 44.4% in the control group, p = 0.5). No adverse effects of hemoperfusion were observed.
conclusionsHemoperfusion with polymyxin B added to CRRT resulted in faster decrease in endotoxin levels, but we observed no improvements in clinical, physiological, or biological parameters.
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