• Toshiaki Ikeda, Kazumi Ikeda, Masatoshi Nagura, Hitoshi Taniuchi, Mikiko Matsushita, Shintarou Kiuchi, Yuichi Kuroki, Kaori Suzuki, and Naoto Matsuno.
• Division of Critical Care and Emergency Medicine, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan. toshi@tokyo-med.ac.jp
• Ther Apher Dial. 2004 Aug 1; 8 (4): 293-8.

AbstractEndotoxin-adsorbing fibers have been applied to treat septic shock patients. The limitations of endotoxin hemoadsorption therapy (PMX-DHP) and the optimal time to start PMX-DHP were examined in patients with septic multiple organ failure with hypercytokinemia (interleukin-6 = 1000 pg/mL). Subjects were separated into those who survived more than 28 days after the start of PMX-DHP therapy (S group) and those who did not (N-S group). Severity of symptoms and background factors, blood biochemical parameters, hemodynamic parameters, PaO(2)/FiO(2), pathogens, endotoxin, cytokines, and vascular endothelial cell function-related markers were examined before and after PMX-DHP. Number of days from onset of shock (or symptom development) to PMX-DHP initiation was longer in the N-S group than in the S group. These results suggest that PMX-DHP could save more lives in patients with septic multiple organ failure with IL-6 = 1000 pg/mL when applied early after the onset of shock.

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