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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
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.
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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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