Effect of polymyxin B-immobilized fibre on various mediators in patients with hypothermic sepsis

Abstract

Objective: We compared the effects of polymyxin B-immobilized fibre (PMX-F) therapy and conventional treatment on plasma concentrations of various mediators in patients with hypothermic sepsis. Design and subjects: One-hundred and twenty febrile and 20 hypothermic sepsis patients and 40 healthy controls were included in this study. Plasma levels of thrombomudulin (TM) and von Willebrand factor (vWF) were measured by enzyme immunoassay. Plasma levels of erythropoietin (EPO) and interleukin (IL)-6 were measured by enzyme-linked immunosorbent assay. Hypothermic sepsis patients were divided into two treatment groups: PMX-F treatment group (group A, n=10) and conventional treatment group (group B, n=10). Results: Plasma endotoxin, TM, vWF, IL-6 and EPO concentrations were significantly higher in hypothermic sepsis patients than in febrile sepsis patients (p<0.05 or p<0.001). The survival rate was 60% in group A and 10% in group B. PMX-F reduced these concentrations significantly in group A (p<0.01) while conventional treatments did not affect these concentrations. Conclusion: Hypothermic sepsis is associated with amplified TM, vWF, IL-6 and EPO concentrations. PMX-F may be effective in reducing these factors in hypothermic sepsis patients.