2014 Volume 5 Issue 2 Pages 156-159
Japan Society for Premature and Newborn Medicine neonatal extra-corporeal hemofiltration guidelines recommend priming with blood products which have corrected levels of potassium, calcium and bicarbonate to prevent hypotension and a reduction in colloid osmotic pressure. We describe a new method of correction in endotoxin absorption therapy by direct hemoperfusion using a polymyxin-B immobilized fiber (PMX) column in three neonates ≤ 2 kg with sepsis at our hospital. We designed a circuit with a PMX column and attached a bypass circuit and hemofilter in tandem. The whole circuit was then filled with blood products. For correction of priming solution, the circuit was changed to the bypass circuit and hemofilter. Our method allowed two types of PMX therapy, sole PMX and combined PMX with hemodiafiltration. For sole PMX, blood flow to the bypass circuit and the hemofilter was shut off with forceps. For PMX with hemodiafiltration, the bypass circuit was shut off with forceps, resulting in a circuit with the PMX column and hemofilter. In all three patients, there were no adverse events, and no sequelae following PMX therapy. Our results suggest that our method safely facilitates combined hemodiafiltration therapy using the same circuit.
