Abstract:
BACKGROUND:The definition of sepsis was updated to sepsis-3 in February 2016. Currently, direct hemoperfusion therapy using the polymyxin B-immobilized fiber cartridge (PMX-DHP) is widely performed to treat sepsis and septic shock. However, the prognostic factors of PMX-DHPs in patients with sepsis using the new definition are unclear. We retrospectively assessed prognostic factors in patients who had received PMX-DHP therapy for sepsis and septic shock. METHODS:We included 71 patients with severe infection who underwent PMX-DHP treatment from January 2006 to August 2015 in this study. Participants were re-evaluated according to the criteria of sepsis-3. The patients were divided into two groups based on having survived (n = 59) or not survived (n = 12) for 28 days after PMX-DHP treatment. Clinical data before and after PMX-DHP treatment were compared between the two groups. RESULTS:Non-survivors showed a lower Glasgow Coma Scale (GCS) score before PMX-DHP treatment compared with 28-day survivors [12 (6-14) vs 14 (12-15), 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). Multivariate logistic regression analysis showed that only lower pH after the first PMX-DHP session was a predictor of 28-day mortality independent of age, sex, GCS score, and mean arterial pressure (odds ratio per pH of 0.01, 0.93; 95% confidence interval, 0.83-0.99; P = 0.02). CONCLUSION:The pH after the first PMX-DHP session is an independent risk factor for mortality in patients receiving PMX-DHP for sepsis and septic shock.
journal_name
Clin Exp Nephroljournal_title
Clinical and experimental nephrologyauthors
Okubo A,Nakashima A,Doi S,Ueno T,Sasaki K,Esaki T,Masaki Tdoi
10.1007/s10157-018-1548-4subject
Has Abstractpub_date
2018-10-01 00:00:00pages
1167-1173issue
5eissn
1342-1751issn
1437-7799pii
10.1007/s10157-018-1548-4journal_volume
22pub_type
杂志文章abstract:BACKGROUND:Chronic kidney disease (CKD) is a significant public health problem. Strategy for its early detection is still controversial. This study aims to assess the cost-effectiveness of population strategy, i.e. mass screening, and Japan's health checkup reform. METHODS:Cost-effectiveness analysis was carried out t...
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journal_title:Clinical and experimental nephrology
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doi:10.1007/s10157-008-0038-5
更新日期:2008-06-01 00:00:00
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