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Hemoperfusion With an Immobilized Polymyxin B Fiber Column Decreases Macrophage and Monocyte Activity

Authors

  • Hidehiko Kushi,

    Corresponding author
    1. Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Departments of
    2. Emergency and Critical Care Medicine and
      Dr Hidehiko Kushi, Department of Emergency and Critical Care Medicine, Surugadai Nihon University Hospital, 1-8-13 Kanda, Surugadai, Chiyoda-ku, Tokyo 101-8306, Japan. Email: hkushi@med.nihon-u.ac.jp
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  • Takahiro Miki,

    1. Clinical Engineering, Surugadai Nihon University Hospital, and
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  • Yuichiro Sakagami,

    1. CSL Behring KK, Tokyo, Japan
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  • Jun Sato,

    1. Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Departments of
    2. Emergency and Critical Care Medicine and
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  • Takeshi Saito,

    1. Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Departments of
    2. Emergency and Critical Care Medicine and
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  • Katsuhisa Tanjoh

    1. Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Departments of
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  • Presented in part at the 29th Annual Meeting of the Japanese Society for Apheresis held November 21–23, 2008, in Hiroshima, Japan.

Dr Hidehiko Kushi, Department of Emergency and Critical Care Medicine, Surugadai Nihon University Hospital, 1-8-13 Kanda, Surugadai, Chiyoda-ku, Tokyo 101-8306, Japan. Email: hkushi@med.nihon-u.ac.jp

Abstract

We investigated whether direct hemoperfusion with a polymyxin B column (DHP-PMX) was able to decrease macrophage and monocyte activity in patients with sepsis. Nineteen patients with sepsis were enrolled in the study. They all had signs of systemic inflammatory response syndrome (SIRS) due to infection and a mean arterial blood pressure ≥65 mm Hg (irrespective of the use of catecholamines). A thermodilution catheter was inserted prior to DHP-PMX for intravenous infusion, and DHP-PMX was performed twice within 24 h for 3 h each time. Serum neopterin was measured four times: before DHP-PMX, and 24, 48, 72 h after it had begun. The serum concentrations of neopterin were 654 ± 234 nmol/L prior to DHP-PMX vs. 573 ± 196 nmol/L at 24 h, 452 ± 161 nmol/L at 48 h, and 372 ± 139 nmol/L at 72 h, showing a significant decrease from 48 h onwards compared with before treatment. These data suggest that DHP-PMX decreases macrophage and monocyte activity.

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