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Hiroyuki Yamada, Tatsuo Tsukamoto, Hiromichi Narumiya, Kazumasa Oda, Satoshi Higaki, Ryoji Iizuka, Motoko Yanagita, Masako Deguchi
BACKGROUND: Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP) could improve the hemodynamic status of septic shock patients. As PMX-DHP is an invasive and costly procedure, it is desirable to estimate the therapeutic effect before performing the therapy. However, it is still unclear when this therapy should be started and what type of sepsis it should be employed for. In this study, we retrospectively examined the clinical effect of patients treated with PMX-DHP by using central venous pressure (CVP)...
2016: Journal of Intensive Care
Samel Park, Sunhyo Lee, Suyeon Park, Hyowook Gil, Eunyoung Lee, Jongoh Yang, Saeyong Hong
BACKGROUND: Water soluble and insoluble chemicals in the pesticide formulation may be eliminated more effectively in time if hemodialysis (HD) and hemoperfusion (HP) are performed concurrently. AIM: This study is aimed at evaluating the efficacy of concurrent HP and HD in patients with acute pesticide intoxication. METHODS: Between January 2011 and December 2012, we used HP and HD consecutively (HP-HD group, 347 cases), and then during the next 2 years (January 2013 to December 2014), we used concurrent HP and HD (HPD group, 383 cases)...
October 22, 2016: Blood Purification
Hironobu Tsubouchi, Nobuhiro Matsumoto, Shigehisa Yanagi, Yasuji Arimura, Masamitsu Nakazato
Sepsis is a life-threatening condition caused by the inflammatory response to invading organisms. Polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) is used to reduce blood endotoxin levels and modulate circulating inflammatory cytokine levels in sepsis patients. Here we report that severe sepsis caused by an infection of the gram-negative bacterium Pantoea agglomerans in a patient with small cell lung carcinoma was treated successfully with antibiotics and PMX-DHP. The patient, a 49-year-old Japanese male smoker whose condition was complicated with hyponatremia due to SIADH (syndrome of inappropriate secretion of antidiuretic hormone), rapidly developed sepsis and disseminated intravascular coagulation (DIC) after the administration of cisplatin and irinotecan...
2016: Respiratory Medicine Case Reports
Martin Steinmetz, Georg Nickenig, Tilman Sauerbruch, Florian Eyer, Christian Rabe
No abstract text is available yet for this article.
October 12, 2016: Clinical Toxicology
Barbara S Tauk, Jonathan D Foster
OBJECTIVE: To describe the efficacy of serial charcoal hemoperfusion and hemodialysis in removing ibuprofen from a dog with severe clinical signs of toxicity. CASE SUMMARY: A dog ingested a minimum of 2,200 mg/kg of ibuprofen resulting in progressive neurologic dysfunction that progressed to a comatose state by the time of presentation. Extracorporeal charcoal hemoperfusion coupled serially with hemodialysis was performed to remove ibuprofen from this patient. Serial charcoal hemoperfusion and hemodialysis therapy resulted in complete reversal of the neurologic dysfunction in this dog...
September 26, 2016: Journal of Veterinary Emergency and Critical Care
Anna Sidoti, Etrusca Brogi, Joshua Morse, Michele Collareta, Luigi Vetrugno, Francesco Giunta, Francesco Forfori
Direct hemoperfusion with polymyxin B (PMX-DHP) is an extracorporeal treatment to add to conventional therapy during unresponsive endotoxic septic shock. So far, only heparin has been used as an anticoagulant during polymyxin B therapy. We present a case report of a postsurgical septic patient treated with 2 cycles of PMX-DHP using citrate anticoagulation. Monitoring of serum calcium, postcartridge calcium, and acid-base balance was performed. The treatments were accomplished without complications. To our knowledge, this is the first published report on the use of citrate anticoagulation during PMX-DHP...
September 23, 2016: A & A Case Reports
Yoriko Ishibe, Shigehiro Shibata, Gaku Takahashi, Yasushi Suzuki, Yoshihiro Inoue, Shigeatsu Endo
This study was undertaken to analyze the association of type II secretory phospholipase A2 (sPLA2 -II) and surfactant protein D (SP-D) with the pulmonary oxygenation potential in patients with septic shock during polymyxin-B immobilized fiber-direct hemoperfusion (PMX-DHP). The study was conducted in 25 patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). PMX-DHP lowered the blood endotoxin level in all patients. Following PMX-DHP, there were decreases from day 0 → day 1 → day 2 in both the mean plasma sPLA2 -II level (340 → 260 → 189 ng/mL) and plasma SP-D level (483 → 363 → 252 ng/mL)...
September 13, 2016: Journal of Clinical Apheresis
Risturo Arakawa, Nobuaki Mori, Narito Kagawa, Akiko Higuchi, Masashi Tanaka, Yasuko Aoki, Shiko Seki, Ryo Suzuki
Meningococcal infection is among the most devastating diseases. It is rarely seen in Japan. However, several environmental and host factors have been associated with increased risks of Neisseria meningitidis infection. We present a case of invasive N. meningitidis infection that revealed the presence of multiple myeloma. A 55-year-old Japanese man was admitted with fever and altered consciousness. He was sent to the intensive care unit for septic shock and disseminated intravascular coagulation. In addition to standard septic shock and multiple organ failure treatment, polymyxin-B immobilized column direct hemoperfusion was performed...
May 2016: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
Itaru Ebihara, Kouichi Hirayama, Miho Nagai, Eri Shiina, Megumi Koda, Masanobu Gunji, Yuki Okubo, Chihiro Sato, Joichi Usui, Kunihiro Yamagata, Masaki Kobayashi
Acute kidney injury (AKI) occurs in approximately 50% of patients in septic shock, and mortality from septic AKI is extremely high. Angiopoietin levels may play a role in the pathogenesis of vascular permeability. It was reported that direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX) therapy ameliorates the angiopoietin balance in patients with sepsis. Although dysregulated angiopoietin balance in sepsis has been demonstrated, mechanisms underlying the development of AKI in sepsis have not been identified...
August 2016: Therapeutic Apheresis and Dialysis
D X Wang, X D Jian, H L Liu
No abstract text is available yet for this article.
May 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
J R Wang, G Y Zhao
OBJECTIVE: To investigate the combination of drugs in blood perfusion-based rescue therapy of acute poisoning thinners. METHODS: Our department were retrospectively analyzed in May 2011 to October 2014, 54 cases thinners poisoning patients choose the thinner should be 44 cases of acute poisoning patients were divided into two groups. Toluene, xylene group 8 cases; Halogenated hydrocarbon group 34cases; Give blood perfusion 3 to 7 times, compared before and after the blood perfusion of toxicant concentration, results and biochemical indicators...
May 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
Rémi Coudroy, Didier Payen, Yoann Launey, Anne-Claire Lukaszewicz, Mahmoud Kaaki, Benoit Veber, Olivier Collange, Antoine Dewitte, Laurent Martin-Lefevre, Matthieu Jabaudon, Thomas Kerforne, Martine Ferrandière, Eric Kipnis, Carlos Vela, Stéphanie Chevalier, Jihad Mallat, Sandrine Charreau, Jean-Claude Lecron, René Robert
Conflicting results have been reported on the influence of Polymyxin-B hemoperfusion treatment on systemic inflammation markers. The aim of study was to assess in a randomized control trial the influence on plasma cytokine concentrations of Polymyxin-B hemoperfusion in septic shock due to peritonitis. A panel of 10 pro- or anti-inflammatory cytokines was measured in 213 patients with peritonitis-induced septic shock enrolled in the randomized trial ABDOMIX testing the impact of 2 Polymyxin-B hemoperfusion sessions with standard treatment...
August 8, 2016: Shock
Salvatore Lucio Cutuli, Antonio Artigas, Roberto Fumagalli, Gianpaola Monti, Vito Marco Ranieri, Claudio Ronco, Massimo Antonelli
BACKGROUND: In 2010, the EUPHAS 2 collaborative group created a registry with the purpose of recording data from critically ill patients suffering from severe sepsis and septic shock treated with polymyxin-B hemoperfusion (PMX-HP) for endotoxin removal. The aim of the registry was to verify the application of PMX-HP in the daily clinical practice. METHODS: The EUPHAS 2 registry involved 57 centers between January 2010 and December 2014, collecting retrospective data of 357 patients (297 in Europe and 60 in Asia) suffering from severe sepsis and septic shock caused by proved or suspected infection related to Gram negative bacteria...
December 2016: Annals of Intensive Care
Tomonori Takazawa, Jou Ohta, Tatsuo Horiuchi, Hiroshi Hinohara, Fumio Kunimoto, Shigeru Saito
BACKGROUND: Gas gangrene is a necrotic infection of soft tissue associated with high mortality rates. We report a case of postoperative gas gangrene with very acute onset and rapid progression of symptoms. To our knowledge, this case is the most acute onset of postoperative gas gangrene ever reported. CASE PRESENTATION: A 65-year-old Japanese female patient developed a shock state 16 h after radical cystectomy with ileal conduit reconstruction. Two days after the operation, she was transferred to the intensive care unit because of deterioration in her respiratory and circulatory condition...
2016: BMC Research Notes
Shinya Chihara, Yoshiki Masuda, Hiroomi Tatsumi, Kota Nakano, Tomokazu Shimada, Takao Murohashi, Michiaki Yamakage
This study was conducted to clarify the effectiveness of induction timing of direct hemoperfusion with a polymyxin-B immobilized column (PMX-DHP) for amelioration of hemodynamic derangement and outcome in patients with septic shock. Suspected Gram-negative septic shock patients who received PMX-DHP therapy from January 2010 to December 2014 in our ICU were enrolled in this study. The patients were divided into two groups that received PMX-DHP therapy within 8 h (early group) and more than 8 h (late group) from catecholamine administration...
July 28, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Kazuhito Minami, Yoshihisa Sakaguchi, Daisuke Yoshida, Manabu Yamamoto, Masahiko Ikebe, Masaru Morita, Yasushi Toh
BACKGROUND: Clostridium difficile (CD)-associated colitis (CDAC) is endemic and a common nosocomial enteric disease encountered by surgeons in modern hospitals due to prophylactic or therapeutic antibiotic therapies. Currently, the incidence of fulminant CDAC, which readily causes septic shock followed by multiple organ dysfunction syndromes, is increasing. Fulminant CDAC requires surgeons to perform a prompt surgery, such as subtotal colectomy, to remove the septic source. It is known that fulminant CDAC is caused by the shift from an inflammatory response at a local mucosal level to a general systemic inflammatory reaction in which CD toxin-induced mediators' cascades disseminate...
December 2016: Surgical Case Reports
Chen-Meng Kuan, Szu-Ting Lin, Tzung-Hai Yen, Yu-Lin Wang, Chao-Min Cheng
This article unveils the development of a paper-based analytical device designed to rapidly detect and clinically diagnose paraquat (PQ) poisoning. Using wax printing technology, we fabricated a PQ detection device by pattering hydrophobic boundaries on paper. This PQ detection device employs a colorimetric sodium dithionite assay or an ascorbic acid assay to indicate the PQ level in a buffer system or in a human serum system in 10 min. In this test, colorimetric changes, blue in color, were observable with the naked eye...
May 2016: Biomicrofluidics
Marc Ghannoum, Monique Cormier, Amélie Bernier-Jean, Dave Brindamour, Clément Déziel, Josée Bouchard
INTRODUCTION: Intentional dapsone intoxication can be life-threatening. There is limited data on the clinical effect of extracorporeal treatments (ECTRs) on dapsone elimination. We describe a case of severe dapsone toxicity treated with different ECTRs. CASE DETAILS: A 23-year-old woman was admitted 2.5 h after ingesting 2.2 g of dapsone. She developed methemoglobinemia (39.9%) and showed signs of toxicity (hemodynamic instability and altered mental status) despite multiple-activated charcoal, methylene blue, vasopressors and endotracheal intubation...
July 18, 2016: Clinical Toxicology
Gianluigi Li Bassi, Joan Daniel Marti, Eli Aguilera Xiol, Talitha Comaru, Francesca De Rosa, Montserrat Rigol, Silvia Terraneo, Mariano Rinaudo, Laia Fernandez, Miguel Ferrer, Antoni Torres
BACKGROUND: Hemoperfusion through a column containing polymyxin B-immobilized fiber (PMX-HP) is beneficial in abdominal sepsis. We assessed the effects of PMX-HP in a model of severe Pseudomonas aeruginosa pneumonia. METHODS: Eighteen pigs with severe P. aeruginosa pneumonia were mechanically ventilated for 76 h. Pigs were randomized to receive standard treatment with fluids and vasoactive drugs, or standard treatment with two 3-h PMX-HP sessions. Antibiotics against P...
December 2016: Annals of Intensive Care
Winnie Kwai Yu Chan, Wun Fung Hui
BACKGROUND: High-dose methotrexate therapy (HDMTX) is a common form of chemotherapy used in children with high-grade malignancy such as osteosarcoma. Treatment with HDMTX requires careful monitoring of drug levels with folinic acid (leucovorin) rescue therapy. Toxicity from methotrexate is not uncommon and sometimes causes significant morbidity and mortality. CASE-DIAGNOSIS/TREATMENT: We report an 11-year-old child whose 24-h post-HDMTX serum level was 651.8 μmol/L (recommended level <20 μmol/L), which was complicated by septic shock and progressive renal and liver failure...
October 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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