Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock
<b>Background</b>: We aimed to analyze the correlation between in-hospital mortality and hemodynamic changes, using polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) initiation time in patients with cancer with refractory septic shock. <b>Methods</b>: Forty-...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/13/4/1009 |
| _version_ | 1797297896227340288 |
|---|---|
| author | Jae Hoon Lee Won Ho Han Hyun-jae Im Jee Hee Kim |
| author_facet | Jae Hoon Lee Won Ho Han Hyun-jae Im Jee Hee Kim |
| author_sort | Jae Hoon Lee |
| collection | DOAJ |
| description | <b>Background</b>: We aimed to analyze the correlation between in-hospital mortality and hemodynamic changes, using polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) initiation time in patients with cancer with refractory septic shock. <b>Methods</b>: Forty-six patients with cancer who received PMX-DHP for refractory septic shock were retrospectively analyzed and classified into early (≤3 h between refractory septic shock and PMX-DHP; <i>n</i> = 17) and late (>3 h; <i>n</i> = 29) initiation groups. The vasopressor inotropic score (<i>VIS</i>), sequential organ failure assessment (SOFA) score, and lactate clearance before and 24 h post-PMX-DHP were compared. <b>Results</b>: Overall, 52.17% died from multiple organ dysfunction, with a lower mortality rate in the early initiation group. The <i>VIS</i> and SOFA score decreased in both groups, but the magnitude of decrease was not significant. Lactate clearance improved in both groups, with greater improvement in the early initiation group. Univariable analysis identified associations of in-hospital mortality with early initiation, ΔC-reactive protein, lactate clearance, ΔSOFA score, and Δ<i>VIS</i>. Multivariable analysis demonstrated associations of in-hospital mortality risk with ΔSOFA score and early PMX-DHP initiation. Overall survival was higher in the early initiation group. Early initiation of PMX-DHP in patients with cancer with refractory septic shock reduced in-hospital mortality and improved lactate clearance. |
| first_indexed | 2024-03-07T22:27:00Z |
| format | Article |
| id | doaj.art-c62ad185199d48008eac892679c1390e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-07T22:27:00Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-c62ad185199d48008eac892679c1390e2024-02-23T15:22:01ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-01134100910.3390/jcm13041009Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic ShockJae Hoon Lee0Won Ho Han1Hyun-jae Im2Jee Hee Kim3Critical Care Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of KoreaCritical Care Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of KoreaCritical Care Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of KoreaUijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu 11759, Republic of Korea<b>Background</b>: We aimed to analyze the correlation between in-hospital mortality and hemodynamic changes, using polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) initiation time in patients with cancer with refractory septic shock. <b>Methods</b>: Forty-six patients with cancer who received PMX-DHP for refractory septic shock were retrospectively analyzed and classified into early (≤3 h between refractory septic shock and PMX-DHP; <i>n</i> = 17) and late (>3 h; <i>n</i> = 29) initiation groups. The vasopressor inotropic score (<i>VIS</i>), sequential organ failure assessment (SOFA) score, and lactate clearance before and 24 h post-PMX-DHP were compared. <b>Results</b>: Overall, 52.17% died from multiple organ dysfunction, with a lower mortality rate in the early initiation group. The <i>VIS</i> and SOFA score decreased in both groups, but the magnitude of decrease was not significant. Lactate clearance improved in both groups, with greater improvement in the early initiation group. Univariable analysis identified associations of in-hospital mortality with early initiation, ΔC-reactive protein, lactate clearance, ΔSOFA score, and Δ<i>VIS</i>. Multivariable analysis demonstrated associations of in-hospital mortality risk with ΔSOFA score and early PMX-DHP initiation. Overall survival was higher in the early initiation group. Early initiation of PMX-DHP in patients with cancer with refractory septic shock reduced in-hospital mortality and improved lactate clearance.https://www.mdpi.com/2077-0383/13/4/1009sepsisin-hospital mortalityrisk factorshemodynamicslactate clearanceorgan failure |
| spellingShingle | Jae Hoon Lee Won Ho Han Hyun-jae Im Jee Hee Kim Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock Journal of Clinical Medicine sepsis in-hospital mortality risk factors hemodynamics lactate clearance organ failure |
| title | Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock |
| title_full | Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock |
| title_fullStr | Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock |
| title_full_unstemmed | Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock |
| title_short | Effects of Early Initiation of Polymyxin B Hemoperfusion Therapy in Patients with Cancer with Refractory Septic Shock |
| title_sort | effects of early initiation of polymyxin b hemoperfusion therapy in patients with cancer with refractory septic shock |
| topic | sepsis in-hospital mortality risk factors hemodynamics lactate clearance organ failure |
| url | https://www.mdpi.com/2077-0383/13/4/1009 |
| work_keys_str_mv | AT jaehoonlee effectsofearlyinitiationofpolymyxinbhemoperfusiontherapyinpatientswithcancerwithrefractorysepticshock AT wonhohan effectsofearlyinitiationofpolymyxinbhemoperfusiontherapyinpatientswithcancerwithrefractorysepticshock AT hyunjaeim effectsofearlyinitiationofpolymyxinbhemoperfusiontherapyinpatientswithcancerwithrefractorysepticshock AT jeeheekim effectsofearlyinitiationofpolymyxinbhemoperfusiontherapyinpatientswithcancerwithrefractorysepticshock |