Title |
Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial
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Published in |
Intensive Care Medicine, April 2015
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DOI | 10.1007/s00134-015-3751-z |
Pubmed ID | |
Authors |
Didier M. Payen, Joelle Guilhot, Yoann Launey, Anne Claire Lukaszewicz, Mahmoud Kaaki, Benoit Veber, Julien Pottecher, Olivier Joannes-Boyau, Laurent Martin-Lefevre, Matthieu Jabaudon, Olivier Mimoz, Rémi Coudroy, Martine Ferrandière, Eric Kipnis, Carlos Vela, Stéphanie Chevallier, Jihad Mallat, René Robert, The ABDOMIX Group |
Abstract |
To test whether the polymyxin B hemoperfusion (PMX HP) fiber column reduces mortality and organ failure in peritonitis-induced septic shock (SS) from abdominal infections. Prospective, multicenter, randomized controlled trial in 18 French intensive care units from October 2010 to March 2013, enrolling 243 patients with SS within 12 h after emergency surgery for peritonitis related to organ perforation. The PMX HP group received conventional therapy plus two sessions of PMX HP. Primary outcome was mortality on day 28; secondary outcomes were mortality on day 90 and a reduction in the severity of organ failures based on Sequential Organ Failure Assessment (SOFA) scores. Primary outcome: day 28 mortality in the PMX HP group (n = 119) was 27.7 versus 19.5 % in the conventional group (n = 113), p = 0.14 (OR 1.5872, 95 % CI 0.8583-2.935). Secondary endpoints: mortality rate at day 90 was 33.6 % in PMX-HP versus 24 % in conventional groups, p = 0.10 (OR 1.6128, 95 % CI 0.9067-2.8685); reduction in SOFA score from day 0 to day 7 was -5 (-11 to 6) in PMX-HP versus -5 (-11 to 9), p = 0.78. Comparable results were observed in the predefined subgroups (presence of comorbidity; adequacy of surgery, <2 sessions of hemoperfusion) and for SOFA reduction from day 0 to day 3. This multicenter randomized controlled study demonstrated a non-significant increase in mortality and no improvement in organ failure with PMX HP treatment compared to conventional treatment of peritonitis-induced SS. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 2 | 13% |
France | 2 | 13% |
Japan | 1 | 7% |
United States | 1 | 7% |
Unknown | 9 | 60% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 9 | 60% |
Scientists | 5 | 33% |
Practitioners (doctors, other healthcare professionals) | 1 | 7% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Italy | 2 | <1% |
France | 1 | <1% |
Brazil | 1 | <1% |
Russia | 1 | <1% |
Japan | 1 | <1% |
Unknown | 203 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 35 | 17% |
Other | 32 | 15% |
Student > Postgraduate | 15 | 7% |
Student > Ph. D. Student | 14 | 7% |
Student > Bachelor | 14 | 7% |
Other | 49 | 23% |
Unknown | 50 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 131 | 63% |
Nursing and Health Professions | 7 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 5 | 2% |
Biochemistry, Genetics and Molecular Biology | 3 | 1% |
Agricultural and Biological Sciences | 3 | 1% |
Other | 10 | 5% |
Unknown | 50 | 24% |