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Open Access 01-06-2015 | Seven-Day Profile Publication

Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial

Authors: Didier M. Payen, Joelle Guilhot, Yoann Launey, Anne Claire Lukaszewicz, Mahmoud Kaaki, Benoit Veber, Julien Pottecher, Olivier Joannes-Boyau, Laurent Martin-Lefevre, Matthieu Jabaudon, Olivier Mimoz, Rémi Coudroy, Martine Ferrandière, Eric Kipnis, Carlos Vela, Stéphanie Chevallier, Jihad Mallat, René Robert, The ABDOMIX Group

Published in: Intensive Care Medicine | Issue 6/2015

Abstract

Purpose

To test whether the polymyxin B hemoperfusion (PMX HP) fiber column reduces mortality and organ failure in peritonitis-induced septic shock (SS) from abdominal infections.

Method

Prospective, multicenter, randomized controlled trial in 18 French intensive care units from October 2010 to March 2013, enrolling 243 patients with SS within 12 h after emergency surgery for peritonitis related to organ perforation. The PMX HP group received conventional therapy plus two sessions of PMX HP. Primary outcome was mortality on day 28; secondary outcomes were mortality on day 90 and a reduction in the severity of organ failures based on Sequential Organ Failure Assessment (SOFA) scores.

Results

Primary outcome: day 28 mortality in the PMX HP group (n = 119) was 27.7 versus 19.5 % in the conventional group (n = 113), p = 0.14 (OR 1.5872, 95 % CI 0.8583–2.935). Secondary endpoints: mortality rate at day 90 was 33.6 % in PMX-HP versus 24 % in conventional groups, p = 0.10 (OR 1.6128, 95 % CI 0.9067–2.8685); reduction in SOFA score from day 0 to day 7 was −5 (−11 to 6) in PMX-HP versus −5 (−11 to 9), p = 0.78. Comparable results were observed in the predefined subgroups (presence of comorbidity; adequacy of surgery, <2 sessions of hemoperfusion) and for SOFA reduction from day 0 to day 3.

Conclusion

This multicenter randomized controlled study demonstrated a non-significant increase in mortality and no improvement in organ failure with PMX HP treatment compared to conventional treatment of peritonitis-induced SS.

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Title: Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial
Authors: Didier M. Payen
Joelle Guilhot
Yoann Launey
Anne Claire Lukaszewicz
Mahmoud Kaaki
Benoit Veber
Julien Pottecher
Olivier Joannes-Boyau
Laurent Martin-Lefevre
Matthieu Jabaudon
Olivier Mimoz
Rémi Coudroy
Martine Ferrandière
Eric Kipnis
Carlos Vela
Stéphanie Chevallier
Jihad Mallat
René Robert
The ABDOMIX Group
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 6/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-015-3751-z

At a glance: The STEP trials

Springer Medicine

Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial

Abstract

Purpose

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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