KLI

Uncertain Clinical Effect of Polymyxin B Hemoperfusion in Patients with Septic Acute Kidney Injury Requiring Continuous Renal Replacement Therapy

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Abstract
Polymyxin B hemoperfusion (PMX-HP) may improve the clinical outcomes of patients with sepsis and gram-negative bacteremia by reducing endotoxin levels. However, the recent studies with the variable degree of renal support have shown that the improvement of survival rate by PMX-HP remains unclear in such patients. Therefore, we investigated whether the addition of PMX-HP to continuous renal replacement therapy (CRRT) could improve the survival rate than CRRT alone. This study included 231 patients with sepsis undergoing CRRT alone or PMX-HP with CRRT. Primary outcomes were 28-day and 90-day all-cause mortality. Urine output, ventilator support, and Sequential Organ Failure Assessment (SOFA) score were not significantly different between the two groups. Crude 28-day and 90-day mortality rates were higher in the PMX-HP with CRRT group than in the CRRT-alone group. To correct for disease severity, propensity score (PS) matching was performed with acute respiratory distress syndrome, mechanical ventilation support, extracorporeal membrane oxygenation, infection source (abdomen), age, inotropic score, SOFA score, C-reactive protein, and procalcitonin levels. Sixty-six PS-matched pairs revealed significantly higher 28-day and 90-day mortality rates in the PMX-HP with CRRT group than in the CRRT-alone group. Considering the mortality rates after PS matching, the additional use of PMX-HP does not improve the clinical outcomes of patients with sepsis and acute kidney injury requiring CRRT.
Author(s)
이종민백승돈김태현전화란한진희장재원
Issued Date
2021
Type
Article
Keyword
polymixin Bhemoperfudionsepsisacute kidney injuryCRRT
DOI
10.1097/SHK.0000000000001752
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7235
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2491947396&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Uncertain%20Clinical%20Effect%20of%20Polymyxin%20B%20Hemoperfusion%20in%20Patients%20with%20Septic%20Acute%20Kidney%20Injury%20Requiring%20Continuous%20Renal%20Replacement%20Therapy&offset=0&pcAvailability=true
Publisher
SHOCK
Location
미국
Language
영어
ISSN
1073-2322
Citation Volume
56
Citation Number
4
Citation Start Page
551
Citation End Page
556
Appears in Collections:
Medicine > Medicine
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