, Volume 24, Issue 12, pp 1272-1276

Changes in plasma erythropoietin and interleukin-6 concentrations in patients with septic shock after hemoperfusion with polymyxin B-immobilized fiber

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Abstract

Objective: To find out whether polymyxin B-immobilized fiber (PMX-F) treatment affects the clinical parameters and plasma concentrations of erythropoietin (EPO) and interleukin (IL)-6. Design: A prospective case series study. Setting: Intensive care unit of the Department of Internal Medicine, Misato Junshin Hospital, Saitama, and Koto Hospital, Tokyo, Japan. Patients: 17 consecutive patients (10 men, 7 women; mean age 54.6 years) with clinically defined septic shock and 20 healthy volunteers (12 men, 8 women; mean age 52.2 years). Main results: Of the 17 patients with septic shock, 9 (53 %) survived. The systolic blood pressure increased significantly from 78 ± 6 to 106 ± 8 mm Hg 2 h after PMX-F treatment in patients with septic shock. Plasma endotoxin levels decreased significantly after treatment, from 40 ± 6 to 12 ± 4 pg/ml. The pretreatment plasma concentrations of EPO and IL-6 were significantly higher in the 8 nonsurviving patients with septic shock (EPO: 400 ± 36 mlU/ml; IL-6: 6260 ± 1180 pg/ml) than in the 9 surviving patients (EPO: 120 ± 22 mlU/ml; IL-6: 680 ± 138 pg/ml) and the 20 control subjects (EPO, 12 ± 6 mlU/ml; IL-6, 8 ± 2 pg/ml). Plasma concentrations of EPO and IL-6 in patients with septic shock decreased significantly after PMX-F treatment (EPO, nonsurviving: 320 ± 28 mlU/ml, p < 0.05; survivors: 26 ± 8 mlU/ml, p < 0.001; IL-6, nonsurviving: 3860 ± 840 pg/ml, p < 0.01; survivors: 84 ± 20 pg/ml, p < 0.001). Conclusions: Plasma concentrations of EPO and IL-6 may be prognostic indicators in patients with septic shock: PMX-F treatment may be effective in reducing the plasma concentrations of EPO and IL-6 in patients with septic shock.

Received: 11 February 1998 Accepted: 5 October 1998