Effects of polymyxin B hemoperfusion on hemodynamics and prognosis in septic shock patients (vol 43, pg 202, 2018)

Purpose: We designed this study to examine the clinical effects of polymyxin B hemoperfusion (PMX-HP) in septic shock patients. Material and methods: We retrospectively examined the effects of PMX-HP in septic shock patients with intra-abdominal or gram-negative bacterial infection during October 2013-May 2016. A one-to-one matching between the PMX-HP and conventional groups was performed, and 28-day mortality, and change in inotropic score, Sequential Organ Failure Assessment ( SOFA) score, and Acute Physiology and Chronic Health Evaluation II ( APACHE II) score at 24 h in the two groups were compared. In addition, multivariable regression analysis and Cox proportional hazards regression model were applied in all eligible patients. Results: Sixty-nine patients were eligible, of whom forty-eight patients were enrolled for matched cohort analysis. In matched cohort analysis, median change in inotropic score after 24 h (- 23 [- 33- -3] vs. - 12 [- 19-0], p= 0.007) differed significantly between the PMX-HP and conventional groups. Multivariable regression analysis revealed that PMX-HP was associated with lower 28-day mortality ( odds ratio 0.18, 95% CI 0.04-0.92, p = 0.039) and greater improvement in inotropic and APACHE II scores. Conclusions: PMX-HP may have potential benefits for hemodynamic and prognostic outcomes in septic shock patients with intra-abdominal or gram-negative bacterial infection.