18 research outputs found
Effectiveness of Endotoxin Scattering Photometry for Determining the Efficacy of Polymyxin B-immobilized Fiber Treatment in Septic Shock: Report of a Case
Selection of acute blood purification therapy according to severity score and blood lactic acid value in patients with septic shock
Aim: As an alternative method for acute blood purification therapy,
continuous venovenous hemodiafiltration (CVVHDF) has been reported as
an effective clinical treatment for critically ill patients, but the
optimal column for performing CVVHDF remains controversial. Patients
and Methods: We used direct hemoperfusion using a polymyxin
B-immobilized fiber column (DHP-PMX) to treat 88 patients with septic
shock. To determine the optimal acute blood purification therapy, we
subsequently divided the patients into three groups: the first group
underwent CVVHDF using a polymethylmethacrylate membrane hemofilter
(PMMA) after undergoing DHP-PMX (28 cases), the second group underwent
CVVHDF using a polyacrylonitrile membrane hemofilter (PAN) after
undergoing DHP-PMX (26 cases), and the third group did not undergo
CVVHDF after undergoing DHP-PMX (34 cases). Results: The overall
survival rate was 54.5%, and patient outcome was significantly related
to the Acute Physiology and Chronic Health Evaluation (APACHE) II
score, the sepsis-related organ failure assessment (SOFA) score, and
the blood lactic acid value before treatment (all P<0.0001). Only
the PMMA-CVVHDF group showed a better outcome (survival rate of 78.6%)
compared with the other groups (P = 0.0190). In addition, only the
PMMA-CVVHDF group showed a significant improvement in the blood lactic
acid level on day 3 (P = 0.0011). Conclusion: Our study suggests that
the PMX column might be effective during the early phase of septic
shock, before a high level of lactic acid is present. Furthermore, a
PMMA column might be the most useful column for performing CVVHDF after
DHP-PMX treatment, as suggested by the blood lactic acid value
Selection of acute blood purification therapy according to severity score and blood lactic acid value in patients with septic shock
Aim: As an alternative method for acute blood purification therapy,
continuous venovenous hemodiafiltration (CVVHDF) has been reported as
an effective clinical treatment for critically ill patients, but the
optimal column for performing CVVHDF remains controversial. Patients
and Methods: We used direct hemoperfusion using a polymyxin
B-immobilized fiber column (DHP-PMX) to treat 88 patients with septic
shock. To determine the optimal acute blood purification therapy, we
subsequently divided the patients into three groups: the first group
underwent CVVHDF using a polymethylmethacrylate membrane hemofilter
(PMMA) after undergoing DHP-PMX (28 cases), the second group underwent
CVVHDF using a polyacrylonitrile membrane hemofilter (PAN) after
undergoing DHP-PMX (26 cases), and the third group did not undergo
CVVHDF after undergoing DHP-PMX (34 cases). Results: The overall
survival rate was 54.5%, and patient outcome was significantly related
to the Acute Physiology and Chronic Health Evaluation (APACHE) II
score, the sepsis-related organ failure assessment (SOFA) score, and
the blood lactic acid value before treatment (all P<0.0001). Only
the PMMA-CVVHDF group showed a better outcome (survival rate of 78.6%)
compared with the other groups (P = 0.0190). In addition, only the
PMMA-CVVHDF group showed a significant improvement in the blood lactic
acid level on day 3 (P = 0.0011). Conclusion: Our study suggests that
the PMX column might be effective during the early phase of septic
shock, before a high level of lactic acid is present. Furthermore, a
PMMA column might be the most useful column for performing CVVHDF after
DHP-PMX treatment, as suggested by the blood lactic acid value
Multi-petahertz electron interference in Cr:Al2O3 solid-state material
Signal processing in electronic devices is in the THz regime. Here the authors measure NIR lightwave-field-induced multiple dipole oscillations in Cr:Al2O3 in the time domain reaching PHz scale by using an isolated attosecond pulse and this method shows potential for higher speed signal processing
Effectiveness of early start of direct hemoperfusion with polymyxin B-immobilized fiber columns judging from stabilization in circulatory dynamics in surgical treatment patients
Background: Septic shock remains a major cause of multiple organ
failure and is associated with a high mortality rate. In 1994, direct
hemoperfusion using a polymyxin B-immobilized fiber column (PMX; Toray
Industries Inc., Tokyo Japan) was developed in Japan and has since been
used for the treatment of septic shock arising from endotoxemia.
Materials and Method: We treated 36 patients with septic shock using
direct hemoperfusion with PMX. The patients were analyzed in two groups
based on whether they had undergone surgery prior to DHP-PMX treatment
(surgical group: surgical treatment before DHP-PMX, medical group: no
surgical treatment). In surgical group, DHP-PMX was started within
three hours after the surgical treatment. Various factors were measured
before and after DHP-PMX. Results: The mean Acute Physiology and
Chronic Health Evaluation (APACHE) II score was 27.4 ± 8.8, and
the mean sepsis-related organ failure assessment (SOFA) score was 11.8
± 4.9 before DHP-PMX. The SOFA score was significantly higher (P =
0.0091) and the PaO2/FiO2 ratio (P/F ratio) was significantly lower (P
= 0.0037) in medical group than in surgical group prior to DHP-PMX. A
chi-square test showed that the survival rate in surgical group was
significantly better than in medical group (P = 0.0027). The survival
rate of surgical group (84.2%) was judged to be very good because the
predicated survival rate based on the APACHE II score (25.0) was only
46.5%. On the other hand, the survival rate of medical group (35.3%)
was almost equal to that predicted by the APACHE II score (30.6;
predicted survival rate, 27.4%). Conclusion: The results of this study
suggest the utility of early DHP-PMX in surgical group