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Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315922
EISBN: 978-3-8055-9485-1
..., has a key role in the pathogenesis of sepsis and septic shock. High levels of endotoxin activity are associated with worse clinical outcomes [ 1 ]. However, the effectiveness of endotoxin-targeted therapy is still controversial [ 2 , 3 ]. Since the 1970s, polymyxin B (PMX) was discovered...
Book Chapter
Series: Contributions to Nephrology
Volume: 196
Published: 09 August 2018
10.1159/000485725
EISBN: 978-3-318-06298-4
... by the polymyxin B-immobilized fiber column (PMX). PMX has been used for decades in Europe. Results of a North American randomized controlled trial (RCT) on PMX have recently been announced in a press release; results of large-scale observational studies and meta-analyses have also been reported in the last...
Book Chapter
Series: Contributions to Nephrology
Volume: 200
Published: 07 August 2023
10.1159/000527708
EISBN: 978-3-318-07124-5
...-response relationship between endotoxin levels and adverse outcomes. A rapid assay to measure endotoxin activity has been available for more than a decade, but few studies have synergized the assay with a therapeutic. Polymyxin B hemoperfusion (PMX-HP) leverages a molecule with high affinity for endotoxin...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315920
EISBN: 978-3-8055-9485-1
... and organ damage, including acute renal failure. Polymyxin B (PMX-B) hemoperfusion of septic patients can improve survival and decreasing organ dysfunction by removing circulating LPS. Unfortunately, some clinicians have been slow to adopt this novel therapy due to the lack of understanding of the cellular...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315925
EISBN: 978-3-8055-9485-1
... Abstract There is a large amount of support for the safety of polymyxin-B (PMX-B) hemoperfusion in the treatment of septic shock from Japan and Europe. There is also support for potential efficacy, although randomized controlled trials are few and conflicting. PMX-B hemoperfusion represents...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315921
EISBN: 978-3-8055-9485-1
..., and is thus an ideal potential therapeutic target. Direct hemoperfusion using polymyxin B-immobilized fiber column (PMX-F) has been shown to bind and neutralize endotoxin in both in vitro and in vivo studies. Therefore, this extracorporeal therapy with PMX-F can potentially interrupt the biological cascade...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315924
EISBN: 978-3-8055-9485-1
..., but reflects the severity of illness in critically ill septic shock patients. Extracorporeal EA removal (PMX-HP) was assessed following our ICU clinical practice. PMX-HP seems to have better outcome, but further studies are required to verify this hypothesis. Endotoxin or lipopolysaccharide (LPS...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315917
EISBN: 978-3-8055-9485-1
... of endotoxin in the blood is an enticing approach for treating severe sepsis and septic shock. Selective adsorbent therapy targeting blood endotoxin has been clinically applied for more than 15 years, mainly in Japan and more recently in Italy and other countries. Toraymyxin TM (PMX;Toray, Tokyo, Japan...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315923
EISBN: 978-3-8055-9485-1
... Abstract Background: We evaluated the ability of the endotoxin activity (EA) assay to determine the need for early intervention for endotoxemia using polymyxin B-based hemoperfusion (PMX-DHP) on septic patients. Methods: Twenty-four patients were enrolled. Eleven patients had a high EA...
Book
Book Cover Image
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/isbn.978-3-8055-9485-1
EISBN: 978-3-8055-9485-1
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315926
EISBN: 978-3-8055-9485-1
... was found to be 32% (11/34 patients) in the PMX group compared to 53% (16/30 patients) in the conventional therapy group (unadjusted HR: 0.43, 95% CI: 0.20-0.94; adjusted HR: 0.36, 95% CI: 0.16-0.80). In conclusion, the EUPHAS study results are in agreement with those shown in the systematic review...
Book Chapter
Series: Contributions to Nephrology
Volume: 156
Published: 10 May 2007
10.1159/000102138
EISBN: 978-3-318-01456-3
... hemoperfusionwith polymyxin-B-immobilized fiber (PMX-F) is a promising treatment of gramnegativesepsis in critically ill patients. Because of the high affinity of polymyxin B forendotoxin, the rationale underlying extracorporeal therapy would be to remove circulating endotoxinby adsorption, thus preventing...
Book Chapter
Series: Contributions to Nephrology
Volume: 194
Published: 26 April 2018
10.1159/000485603
EISBN: 978-3-318-06307-3
... patients to establish the real clinical influence of this device on short- and long-term outcomes. Another use of this cartridge is the intended removal of cytokines in patients undergoing cardiopulmonary bypass for cardiac surgery. The technique of polymyxin-B (PMX) hemoperfusion for endotoxin removal...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
10.1159/000315918
EISBN: 978-3-8055-9485-1
... and antiendotoxin capabilities; in fact, it is able to compromise the bacterial outer membrane and bind lipopolysaccharides, thereby neutralizing its toxic effects. Extracorporeal hemoperfusion treatments based on cartridges containing PMB-immobilized fibers (Toraymyxin PMX-F; Toray Industries, Tokyo, Japan...
Book Chapter
Series: Contributions to Nephrology
Volume: 167
Published: 02 June 2010
EISBN: 978-3-8055-9485-1
...: Clinical evaluation of PMX-DHP for hypercytokinemia caused by septic multiple organ failure. Ther Apher Dial 2004;8:293-298 12. Nakamura T, Kawagoe Y, Matsuda T, Shoji H, Ueda Y, Tamura N, Ebihara I, Koide H: Effect of polymyxin B-immobilized fiber on blood metalloproteinase-9 and tissue inhibitor...
Book Chapter
Series: Contributions to Nephrology
Volume: 190
Published: 29 May 2017
10.1159/000468911
EISBN: 978-3-318-06061-4
... membrane oxygenation applied in the context of cardiac surgery. Polymyxin-B-HP In the area of sorbents applied to blood purification, the technique of polymyxin-B (PMX) HP for endotoxin removal has gained important evidence and results [ 16 , 17 ]. This direct HP technique utilizes a unit in which...
Book Chapter
Series: Contributions to Nephrology
Volume: 200
Published: 07 August 2023
10.1159/000527583
EISBN: 978-3-318-07124-5
...-venous hemodialysis [ 25 ]. There was no difference in time to resolution of shock, median catecholamine use, decrease in inflammatory parameters, and ICU mortality between the two groups. Polymyxin B-Immobilized Hemoperfusion Polymyxin B-immobilized hemoperfusion (PMX-HP) or Toraymyxin®...
Book Chapter
Series: Contributions to Nephrology
Volume: 200
Published: 07 August 2023
10.1159/000527572
EISBN: 978-3-318-07124-5
... for nonspecific adsorptive sorbents like CytoSorb and Jafron HA will be discussed along with the anticoagulation of specific adsorptive sorbents such as polymyxin-B hemoperfusion (PMX-B-HMP). Lastly, the anticoagulation of more specific techniques like coupled plasma filtration adsorption (CPFA) and double plasma...
Book Chapter
Series: Contributions to Nephrology
Volume: 190
Published: 29 May 2017
10.1159/000468912
EISBN: 978-3-318-06061-4
... increased clearance of antimicrobial agents, electrolyte disturbances and depletion of micronutrients. Hemoperfusion, hemoadsorption and plasma adsorption are techniques in which a sorbent is placed in an extracorporeal circuit in direct contact with blood or plasma, respectively. Polymyxin B (PMX-B...
Book Chapter
Series: Contributions to Nephrology
Volume: 200
Published: 07 August 2023
10.1159/000528056
EISBN: 978-3-318-07124-5
... Hemoadsorption Selective hemoadsorption with polymyxin (PMX)-bound membranes for the removal of endotoxin in patients with sepsis has been extensively studied [ 10 ] with several randomized controlled trials: the EUPHAS randomized controlled trial in 2009 [ 10 ]; the PMX hemoadsorption in peritonitis study...