Abstract
Objectives: We retrospectively analyzed the clinical profiles of patients with septic shock who underwent direct hemoperfusion with polymyxin B immobilized fibers (PMX-DHP) to determine which factors contribute to outcomes. Methods: We compared the clinical results, infection sites and causative organisms (gram-negative or -positive) among 29 patients with septic shock. Circulation status was assessed by the dose of catecholamine use before and after PMX-DHP. Results: The overall survival rate was 66% (19/29). The mortality rates of the patients were: respiratory tract infection, 38% (3/8); abdominal cavity, 25% (1/4); undetermined site, 75% (6/8). All those with infections of the urinary tract (n=5) and lower extremities (n=4) survived. Mortality rates between patients with gram-positive and -negative infection did not significantly differ. The more marked decrease in the dose of catecholamine use was made among survivors than non-survivors. Conclusion: The clinical result might be influenced by the infection site. Positive or negative gram staining did not seem to be related to clinical outcomes. Restoration of collapsed circulation in response to PMX-DHP treatment might be an important factor linked to better outcomes.
