Abstract: TH-PO1118

Prognostic Factors in Sepsis Patients Who Have Undergone Direct Hemoperfusion with Polymyxin B-Immobilized Fibers

Session Information

Category: Fluid, Electrolytes, and Acid-Base

  • 704 Fluid, Electrolyte, Acid-Base Disorders

Authors

  • Okubo, Aiko, Hiroshima University Hospital, Hiroshima, Japan
  • Nakashima, Ayumu, Hiroshima University Hospital, Hiroshima, Japan
  • Doi, Shigehiro, Hiroshima University Hospital, Hiroshima, Japan
  • Ueno, Toshinori, Hiroshima University Hospital, Hiroshima, Japan
  • Masaki, Takao, Hiroshima University Hospital, Hiroshima, Japan
Background

In 2016, the definitions of sepsis and septic shock were reviewed by the Society of Critical Care Medicine and Sequential Organ Failure Assessment (SOFA) and a quick SOFA score was added to those definitions. Direct hemoperfusion therapy with polymyxin B-immobilized fiber cartridge (PMX-DHP) has been widely used to treat sepsis and septic shock. However, prognostic factors are not well understood. We retrospectively assessed the prognostic factors of patients who had received PMX-DHP for sepsis and septic shock.

Methods

Data on 71 patients with severe infection who had undergone PMX-DHP from January 2006 to August 2015 were included in this study. Participants were re-evaluated according to the criteria of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) and all were confirmed to satisfy the new definition of sepsis. The patients were divided into groups based on having survived (n=59) or not survived (n=12) for 28 days after PMX-DHP. Clinical data before and after PMX-DHP were compared between the two groups.

Results

In the non-survivor group, the Glasgow Coma Scale score before PMX-DHP was significantly lower than in the survivor group (12 [6 to 14] vs 14 [12 to 15], P<0.01). Furthermore, pH after the first PMX-DHP session was significantly lower in non-survivors than in survivors (7.28±0.23 vs 7.39±0.06, P=0.03). The only factor identified by multivariate analysis as significantly associated with 28-day mortality was pH after the first PMX-DHP session (odds ratio, 0.93; 95% CI, 0.83–0.99; P=0.02).

Conclusion

pH after the first PMX-DHP session is an independent risk factor for mortality in patients receiving PMX-DHP for sepsis and septic shock.