Sepsis-induced cardiomyopathy successfully treated by prompt, polymyxin B column-direct hemoperfusion combined with continuous hemodiafiltration

Abstract

Sepsis-induced cardiomyopathy, in which myocardial trauma is caused by sepsis, has been previously reported and is usually a reversible myocardial disorder requiring several days recovery after sepsis has been cured. We report a case of sepsis-induced cardiomyopathy due to an obstructive urinary tract infection followed by rapid deterioration. The patient’s life was saved by improvement of circulatory dynamics using polymyxin B column-direct hemoperfusion (PMX-DHP) and a polymethyl methacrylate membrane combined with continuous hemodiafiltration (PMMA- CHDF). This intervention removed the need for percutaneous cardiopulmonary support (PCPS). In this case, blood purification therapy rapidly restored cardiac function. Thus endotoxin and cytokine removal using PMX-DHP or PMMA-CHDF should be considered for efficient restoration of cardiac function in cases of life threatening sepsis-induced cardiomyopathy.