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Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial
PURPOSE: To test whether the polymyxin B hemoperfusion (PMX HP) fiber column reduces mortality and organ failure in peritonitis-induced septic shock (SS) from abdominal infections. METHOD: Prospective, multicenter, randomized controlled trial in 18 French intensive care units from October 2010 to Ma...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477725/ https://www.ncbi.nlm.nih.gov/pubmed/25862039 http://dx.doi.org/10.1007/s00134-015-3751-z |
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author | Payen, Didier M. Guilhot, Joelle Launey, Yoann Lukaszewicz, Anne Claire Kaaki, Mahmoud Veber, Benoit Pottecher, Julien Joannes-Boyau, Olivier Martin-Lefevre, Laurent Jabaudon, Matthieu Mimoz, Olivier Coudroy, Rémi Ferrandière, Martine Kipnis, Eric Vela, Carlos Chevallier, Stéphanie Mallat, Jihad Robert, René |
author_facet | Payen, Didier M. Guilhot, Joelle Launey, Yoann Lukaszewicz, Anne Claire Kaaki, Mahmoud Veber, Benoit Pottecher, Julien Joannes-Boyau, Olivier Martin-Lefevre, Laurent Jabaudon, Matthieu Mimoz, Olivier Coudroy, Rémi Ferrandière, Martine Kipnis, Eric Vela, Carlos Chevallier, Stéphanie Mallat, Jihad Robert, René |
author_sort | Payen, Didier M. |
collection | PubMed |
description | PURPOSE: To test whether the polymyxin B hemoperfusion (PMX HP) fiber column reduces mortality and organ failure in peritonitis-induced septic shock (SS) from abdominal infections. METHOD: Prospective, multicenter, randomized controlled trial in 18 French intensive care units from October 2010 to March 2013, enrolling 243 patients with SS within 12 h after emergency surgery for peritonitis related to organ perforation. The PMX HP group received conventional therapy plus two sessions of PMX HP. Primary outcome was mortality on day 28; secondary outcomes were mortality on day 90 and a reduction in the severity of organ failures based on Sequential Organ Failure Assessment (SOFA) scores. RESULTS: Primary outcome: day 28 mortality in the PMX HP group (n = 119) was 27.7 versus 19.5 % in the conventional group (n = 113), p = 0.14 (OR 1.5872, 95 % CI 0.8583–2.935). Secondary endpoints: mortality rate at day 90 was 33.6 % in PMX-HP versus 24 % in conventional groups, p = 0.10 (OR 1.6128, 95 % CI 0.9067–2.8685); reduction in SOFA score from day 0 to day 7 was −5 (−11 to 6) in PMX-HP versus −5 (−11 to 9), p = 0.78. Comparable results were observed in the predefined subgroups (presence of comorbidity; adequacy of surgery, <2 sessions of hemoperfusion) and for SOFA reduction from day 0 to day 3. CONCLUSION: This multicenter randomized controlled study demonstrated a non-significant increase in mortality and no improvement in organ failure with PMX HP treatment compared to conventional treatment of peritonitis-induced SS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00134-015-3751-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4477725 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-44777252015-06-24 Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial Payen, Didier M. Guilhot, Joelle Launey, Yoann Lukaszewicz, Anne Claire Kaaki, Mahmoud Veber, Benoit Pottecher, Julien Joannes-Boyau, Olivier Martin-Lefevre, Laurent Jabaudon, Matthieu Mimoz, Olivier Coudroy, Rémi Ferrandière, Martine Kipnis, Eric Vela, Carlos Chevallier, Stéphanie Mallat, Jihad Robert, René Intensive Care Med Seven-Day Profile Publication PURPOSE: To test whether the polymyxin B hemoperfusion (PMX HP) fiber column reduces mortality and organ failure in peritonitis-induced septic shock (SS) from abdominal infections. METHOD: Prospective, multicenter, randomized controlled trial in 18 French intensive care units from October 2010 to March 2013, enrolling 243 patients with SS within 12 h after emergency surgery for peritonitis related to organ perforation. The PMX HP group received conventional therapy plus two sessions of PMX HP. Primary outcome was mortality on day 28; secondary outcomes were mortality on day 90 and a reduction in the severity of organ failures based on Sequential Organ Failure Assessment (SOFA) scores. RESULTS: Primary outcome: day 28 mortality in the PMX HP group (n = 119) was 27.7 versus 19.5 % in the conventional group (n = 113), p = 0.14 (OR 1.5872, 95 % CI 0.8583–2.935). Secondary endpoints: mortality rate at day 90 was 33.6 % in PMX-HP versus 24 % in conventional groups, p = 0.10 (OR 1.6128, 95 % CI 0.9067–2.8685); reduction in SOFA score from day 0 to day 7 was −5 (−11 to 6) in PMX-HP versus −5 (−11 to 9), p = 0.78. Comparable results were observed in the predefined subgroups (presence of comorbidity; adequacy of surgery, <2 sessions of hemoperfusion) and for SOFA reduction from day 0 to day 3. CONCLUSION: This multicenter randomized controlled study demonstrated a non-significant increase in mortality and no improvement in organ failure with PMX HP treatment compared to conventional treatment of peritonitis-induced SS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00134-015-3751-z) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2015-04-11 2015 /pmc/articles/PMC4477725/ /pubmed/25862039 http://dx.doi.org/10.1007/s00134-015-3751-z Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Seven-Day Profile Publication Payen, Didier M. Guilhot, Joelle Launey, Yoann Lukaszewicz, Anne Claire Kaaki, Mahmoud Veber, Benoit Pottecher, Julien Joannes-Boyau, Olivier Martin-Lefevre, Laurent Jabaudon, Matthieu Mimoz, Olivier Coudroy, Rémi Ferrandière, Martine Kipnis, Eric Vela, Carlos Chevallier, Stéphanie Mallat, Jihad Robert, René Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial |
title | Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial |
title_full | Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial |
title_fullStr | Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial |
title_full_unstemmed | Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial |
title_short | Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial |
title_sort | early use of polymyxin b hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial |
topic | Seven-Day Profile Publication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477725/ https://www.ncbi.nlm.nih.gov/pubmed/25862039 http://dx.doi.org/10.1007/s00134-015-3751-z |
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