| Title |
Polymyxin-B hemoperfusion in septic patients: analysis of a multicenter registry
|
|---|---|
| Published in |
Annals of Intensive Care, August 2016
|
| DOI | 10.1186/s13613-016-0178-9 |
| Pubmed ID | |
| Authors |
Salvatore Lucio Cutuli, Antonio Artigas, Roberto Fumagalli, Gianpaola Monti, Vito Marco Ranieri, Claudio Ronco, Massimo Antonelli, The EUPHAS 2 Collaborative Group |
| Abstract |
In 2010, the EUPHAS 2 collaborative group created a registry with the purpose of recording data from critically ill patients suffering from severe sepsis and septic shock treated with polymyxin-B hemoperfusion (PMX-HP) for endotoxin removal. The aim of the registry was to verify the application of PMX-HP in the daily clinical practice. The EUPHAS 2 registry involved 57 centers between January 2010 and December 2014, collecting retrospective data of 357 patients (297 in Europe and 60 in Asia) suffering from severe sepsis and septic shock caused by proved or suspected infection related to Gram negative bacteria. All patients received atleast one cycle of extracorporeal endotoxin removal by PMX-HP. Septic shock was diagnosed in 305 (85.4 %) patients. The most common source of infection was abdominal (44.0 %) followed by pulmonary (17.6 %). Gram negative bacteria represented 60.6 % of the pathogens responsible of infection. After 72 h from the first cycle of PMX-HP, some of the SOFA score components significantly improved with respect to baseline: cardiovascular (2.16 ± 1.77 from 3.32 ± 1.29, p < 0.0001), respiratory (1.95 ± 0.95 from 2.40 ± 1.06, p < 0.001) and renal (1.84 ± 1.77 from 2.23 ± 1.62, p = 0.013). Overall 28-day survival rate was 54.5 % (60.4 % in abdominal and 47.5 % in pulmonary infection). Patients with abdominal infection treated with PMX-HP within 24 h from the diagnosis of septic shock had a 28-day survival rate of 64.5 %. Patients showing a significantly cardiovascular improvement after PMX-HP had a 28-survival rate of 75 % in comparison to the 39 % of patients who did not (p < 0.001). Cox regression analysis found the variation of cardiovascular, respiratory and coagulation SOFA to be independent covariates for 28-day survival. In European patients were observed a higher 28-day (58.8 vs. 34.5 %, p = 0.003), ICU (59 vs. 36.7 %, p = 0.006) and hospital survival rate (53.2 vs. 35 %, p = 0.02) than in Asian patients. However, the two populations were highly heterogeneous in terms of source of infection and severity scores at admission. The EUPHAS 2 is the largest registry conducted outside Japan on the clinical use of PMX-HP in septic patients. Data analysis confirmed the feasibility of PMX-HP to treat septic patients in daily clinical practice, showing clinical benefits associated with endotoxin removal without significant adverse events related to the extracorporeal technique. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 1 | 50% |
| Venezuela, Bolivarian Republic of | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Italy | 2 | 4% |
| Unknown | 54 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Professor | 7 | 13% |
| Other | 6 | 11% |
| Researcher | 5 | 9% |
| Professor > Associate Professor | 5 | 9% |
| Student > Bachelor | 4 | 7% |
| Other | 15 | 27% |
| Unknown | 14 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 32 | 57% |
| Nursing and Health Professions | 3 | 5% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Psychology | 1 | 2% |
| Other | 1 | 2% |
| Unknown | 17 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 December 2016.
All research outputs
#14,858,030
of 22,882,389 outputs
Outputs from Annals of Intensive Care
#788
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#225,394
of 364,241 outputs
Outputs of similar age from Annals of Intensive Care
#21
of 31 outputs
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