2016 Volume 7 Issue 2 Pages 130-133
A 65-year-old man was admitted to our hospital with abdominal peritonitis due to sigmoid colon cancer perforation, and emergent abdominal surgery was performed. While the operation, the patient was developing septic shock, therefore a anesthesiologist administered substantial dose of dopamine and norepinephrine. An hour after the admission to our ICU, Direct Hemoperfusion with Polymyxin B-immobilizer (PMX-DHP) was started. Despite the volume replacement therapy, the administration of vasopressor, and PMX-DHP, unstable blood circulation persisted. Therefore, after 3 hour of PMX-DHP starting, we carried out continuous hemodiafiltration (CHDF) using an AN69ST followed by PMMA membrane hemofilter. After that, he kept blood pressure stable and we gradually decrease catecholamine. Three day later, CHDF was discontinued, and he was discharged from ICU 10 days later. We conclude that the blood purification therapy with a combination of PMX-DHP and CHDF with cytokine-absorbing hemofilter is considered to be effective to achieve early withdrawal from sever septic shock and not to lead multiple organ failure.
