Polymyxin B-Immobilized Fiber Column Hemoperfusion Therapy for Septic Shock

  title={Polymyxin B-Immobilized Fiber Column Hemoperfusion Therapy for Septic Shock},
  author={Chieko Mitaka and Makoto Tomita},
Endotoxin, an outer membrane component of gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin adsorption therapy by polymyxin B-immobilized fiber column hemoperfusion (PMX) has been used for the treatment of septic shock patients in Japan since 1994. The covalent binding of polymyxin B onto the surface of the polystyrene-based carrier fiber in PMX inactivates the endotoxin in the blood without exerting toxicity. This study was performed as a systematic… 

A successful application of adult polymyxin B-immobilized fiber column hemoperfusion to a neonate with septic shock

Hemoperfusion therapy using an adult polymyxin B-immobilized fiber column in a neonate with carbapenem resistant Acinetobacter baumannii septic shock successfully was performed, and there was significant short-lasting improvement in pulmonary oxygenation and hemodynamics, leading to wean the patient from ECMO.

Effectiveness of polymyxin B-direct hemoperfusion (PMX-DHP) therapy using a polymyxin B-immobilized fiber column in patients with post-esophagectomy sepsis

PMX-DHP therapy was safe and effective in improving respiratory and general conditions of patients with severe sepsis and septic shock after esophagectomy and decreased the length of stay in the intensive care unit (ICU).

Direct hemoperfusion using polymyxin-B immobilized fiber for severe septic patients with hematological disorders: a single-center analysis.

Efficacy of polymyxin B‐immobilized fiber column direct hemoperfusion for non‐endotoxin‐associated severe septic shock

A 2-year-old boy who had undergone insertion of a (PELOD) score, a scoring system that enables measurement of the degree of MOF in pediatric patients, survived without any short-term neurological or respiratory sequelae after the onset of septic shock.

Endotoxin Removal: History of a Mission

  • C. Ronco
  • Medicine, Biology
    Blood Purification
  • 2014
This review will outline the meaning of the targeted approach to endotoxin, both highlighting the specific immunologic effect of endotoxin removal by polymyxin B and the evidence of clinical improvements following this kind of therapy in terms of recovery of organ function.

Initial Experience of Using Polymyxin B Hemoperfusion in Abdominal Septic Shock: Things to Consider for Better Outcome

Direct hemoperfusion with polymyxin B was proposed in 1983 as an effective treatment modality for sepsis and has a high affinity for GNB endotoxin, and it can be immobilized onto the polystyrene.

Clinical Effects and Outcomes After Polymyxin B–Immobilized Fiber Column Direct Hemoperfusion Treatment for Septic Shock in Preterm Neonates*

Polymyxin B–immobilized fiber column direct hemoperfusion treatment for preterm infants with septic shock due to early-onset sepsis is associated with earlier hemodynamic and respiratory status improvements and with lower mortality than that due to late-onsetssepsis.

Alteco endotoxin hemoadsorption in Gram-negative septic shock patients

This study could not identify any clinical benefit on the addition of Alteco endotoxin hemoadsorption to conventional therapy in patients who suffered from intra-abdominal sepsis with shock.

Polymyxin B Hemoperfusion in Pneumonic Septic Shock Caused by Gram-Negative Bacteria

A case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion is reported.

Polymyxin B hemoperfusion improveshemodynamic status in patients withsepsis with both gram-negative and nongram-negative bacteria

PMX therapy is effective to improve hemodynamic status of septic patients not only with gram-negative but with non-gram-negative bacteria, and there is no significant deference between these groups.




It is suggested that a longer duration of PMX treatment may improve the pulmonary oxygenation associated with decreased adhesion molecules in septic shock.

Polymyxin B-immobilized fiber hemoperfusion in patients with sepsis

The data suggest that PMX-F hemoperfusion is superior to conventional treatment in patients with sepsis and is effective in reducing endotoxin and blood inflammation mediators in surviving septic patients.

Apheresis of Activated Leukocytes with an Immobilized Polymyxin B Filter In Patients with Septic Shock

Results suggest that PMX-DHP selectively removes activated neutrophils and reduces the ability of circulating cells to cause endothelial damage and may improve the systemic inflammatory response in patients with septic shock.

Specific Removal of Monocytes from Peripheral Blood of Septic Patients by Polymyxin B-immobilized Filter Column.

It is demonstrated that PMX also specifically bound monocytes from the peripheral blood leukocytes of septic patients by mean of an analysis of bound cells using immunocytochemical and electron microscopic techniques.

Early hemoperfusion with an immobilized polymyxin B fiber column eliminates humoral mediators and improves pulmonary oxygenation

The mechanism of action of DHP-PMX is still not fully understood, but it appears that improvement in the PaO2/FiO2 ratio appeared to be related to the decreases in blood NE and IL-8 levels.

Endotoxin Adsorption Therapy for Septic Shock Using Polymyxin B‐Immobilized Fibers (PMX): Evaluation by High‐sensitivity Endotoxin Assay and Measurement of the Cytokine Production Capacity

  • M. KojikaN. Sato Sigeatu Endo
  • Medicine, Biology
    Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
  • 2006
PMX‐DHP was associated with elevation of the mean arterial pressure and urine output, reduction in the mean dose requirement of vasopressor agents, and recovery from the shock state in all the patients, and the PaO2/FIO2 ratio also showed significant improvement.

Multi-Scale Analysis of the Toraymyxin Adsorption Cartridge Part I: Molecular Interaction of Polymyxin B with Endotoxins

The aim of this study is the characterization of the polymyxin B-endotoxin system at the molecular level, thus providing quantitative evaluation of the binding forces exerted in the molecular complex, and determining the binding force behavior at different intermolecular distances.

Treatment with polymyxin B-immobilized fiber reduces platelet activation in septic shock patients: Decrease in plasma levels of soluble P-selectin, platelet factor 4 and β-thromboglobulin

The findings suggest that soluble P-selectin, PF-4 and βTG may be associated with septic shock and that PMX-F is effective in reducing these markers in patients with sepsis.

Hemoperfusion with polymyxin B-immobilized fibers reduced the number of CD16+CD14 + monocytes in patients with septic shock

PMX-F treatment was found to be effective in reducing the number of CD 16+CD 14+ monocytes and in decreasing the monocytic expression of TLR-4 in patients with septic shock.