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Efficacy of use of Polymyxin B Hemoperfusion in patients with sepsis: A Korean multicenter cohort study

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Abstract
PURPOSE
Although Polymyxin B hemoperfusion improved the survival of patients with sepsis in a meta-analysis, its effectiveness remains controversial due to the high risk of bias. We aimed to determine whether PMX-HP is effective in sepsis patients.

MATERIALS AND METHODS
This retrospective study evaluated the efficacy of PMX-HP compared with continuous renal replacement therapy (CRRT), in delaying progression to multiple organ failure (MOF) determined using the delta Sequential Organ Failure Assessment (SOFA) scores of 194 critically ill sepsis patients from 15 different hospitals in South Korea. The secondary outcomes included in-hospital mortality rate, length of ICU stay, change in clinical frailty scale, ventilator-free days within 28 days, and length of hospital stay.

RESULTS
Among 194 eligible patients (mean age, 68.9 years; 90[46.9%] women, mean SOFA score 8.61), 41 received Polymyxin B hemoperfusion treatment (PMX-HP), while 153 patients received CRRT. Polymyxin B hemoperfusion did not show advantage of slowing progression in multiple organ failure progression over CRRT (change in SOFA between day0 and day7, 1.83 vs 1.32; p=0.012; change in SOFA between day0 and day14, 1.83 vs 2.17; p=0.368). The 7-day (hazard ratio [HR], 0.182; 95% confidence interval [CI], 0.057 to 0.581; p=0.004), 14-day ([HR], 0.39; 95% [CI], 0.129 to 0.690; p=0.005), 28-day mortality rate ([HR], 0.39; 95% [CI], 0.19 to 0.78; p=0.008) were not significantly different between the two groups. The number of ventilator-free day within 28 days (absolute difference [AD], 0.8 days; standard deviation (SD), 1.36; 95% CI, −3.49 to 1.88; p=0.557), length of ICU stay (AD, 2.15 days; SD, 1.98; 95% CI, −1.75 to 6.06; p=0.278), clinical frailty scale change (p=0.051), and change in the use of vasopressor (p=0.158) were not significantly different between the two groups. Meanwhile, a significant difference was observed in platelet count change (p=0.019) and length of hospital stay (p=0.003) between the two groups.

CONCLUSIONS
In sepsis patients, PMX-HP treatment did not significantly lead to delayed progression to MOF compared with CRRT
Author(s)
이아영
Issued Date
2022
Awarded Date
2022-02
Type
dissertation
URI
https://oak.ulsan.ac.kr/handle/2021.oak/10003
http://ulsan.dcollection.net/common/orgView/200000594736
Affiliation
울산대학교
Department
일반대학원 의학과
Advisor
홍상범
Degree
Master
Publisher
울산대학교 일반대학원 의학과
Language
eng
Rights
울산대학교 논문은 저작권에 의해 보호 받습니다.
Appears in Collections:
Medicine > 1. Theses (Master)
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