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首页> 外文期刊>Esophagus >Effectiveness of polymyxin B-direct hemoperfusion (PMX-DHP) therapy using a polymyxin B-immobilized fiber column in patients with post-esophagectomy sepsis
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Effectiveness of polymyxin B-direct hemoperfusion (PMX-DHP) therapy using a polymyxin B-immobilized fiber column in patients with post-esophagectomy sepsis

机译：固定化多粘菌素B纤维柱的多粘菌素B直接血液灌流（PMX-DHP）治疗在食管切除术后败血症患者中的有效性

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Background Post-esophagectomy complications have an extremely poor prognosis. Recently, polymyxin B-direct hemoperfusion (PMX-DHP) therapy using a polymyxin B-immobilized fiber column was reported to be beneficial in gram-negative and/or gram-positive bacterial sepsis. The present retrospective study investigated the effectiveness and safety of PMX-DHP therapy in severe sepsis or septic shock after esophagectomy. Methods Fifteen severe sepsis or septic shock patients were included. Seven (four, pneumonia; two, anastomotic leakage; and one, reconstructed colon necrosis) patients received 2-5 h of PMX-DHP therapy (PMX-DHP therapy group), whereas 8 (three, pneumonia; three, anastomotic leakage; and two, gastric tube necrosis) received conventional therapy (control group). Results Length of stay in the intensive care unit (ICU) was significantly shorter in the PMX-DHP therapy group than in the conventional therapy group (P = 0.040). In the comparison of pre- and post-PMX-DHP therapy groups, the total Sequential Organ Failure Assessment (SOFA) score, respiratory system score, and P/F ratio improved (P = 0.0027, P = 0.025, and P = 0.0087, respectively) in the post-PMX-DHP therapy group. In the comparison of conventional and PMX-DHP therapy groups, the variations in the total SOFA score, respiratory system score, and P/F ratio improved (P = 0.019, P = 0.0063, and P = 0.0015, respectively) in the PMX-DHP therapy group. Moreover, the respiratory system score was lower (P = 0.0062) in the PMX-DHP therapy group at the time of discharge from the ICU. No adverse effects were observed during the course of PMX-DHP therapy. Conclusions PMX-DHP therapy was safe and effective in improving respiratory and general conditions of patients with severe sepsis and septic shock after esophagectomy and decreased the length of stay in the ICU.
机译：背景食管切除术后并发症的预后极差。最近，据报道，使用固定有多黏菌素B的纤维柱进行的多黏菌素B直接血液灌流（PMX-DHP）治疗对革兰氏阴性和/或革兰氏阳性细菌性脓毒症有益。本回顾性研究调查了PMX-DHP治疗在食管切除术后严重脓毒症或脓毒性休克中的有效性和安全性。方法纳入15例严重脓毒症或脓毒性休克患者。 7例（4例，肺炎; 2例，吻合口漏; 1例重建结肠坏死）接受了2-5小时的PMX-DHP治疗（PMX-DHP治疗组），而8例（3例，肺炎; 3例，吻合口漏;和二，胃管坏死）接受常规治疗（对照组）。结果PMX-DHP治疗组的重症监护病房（ICU）住院时间明显短于常规治疗组（P = 0.040）。在进行PMX-DHP治疗前后的比较中，顺序器官衰竭评估（SOFA）总得分，呼吸系统得分和P / F比得到了改善（P = 0.0027，P = 0.025和P = 0.0087，分别在PMX-DHP后治疗组中进行。在常规组和PMX-DHP治疗组的比较中，PMX-组的总SOFA评分，呼吸系统评分和P / F比的变化得到改善（分别为P = 0.019，P = 0.0063和P = 0.0015）。 DHP治疗组。此外，从ICU出院时，PMX-DHP治疗组的呼吸系统评分较低（P = 0.0062）。在PMX-DHP治疗过程中未观察到不良反应。结论PMX-DHP治疗对食管切除术后严重脓毒症和败血性休克患者的呼吸系统和一般状况改善安全，有效，并缩短了ICU住院时间。

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