Time to administer polymyxin B hemoperfusion and hemodynamics in patients with septic shock requiring high-dose norepinephrine: a predetermined analysis of a prospective cohort study
Background Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. Methods BEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock r...
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| Published in | Critical care (London, England) Vol. 29; no. 1; p. 187 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BioMed Central
09.05.2025
BioMed Central Ltd |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1364-8535 1466-609X 1364-8535 1466-609X 1366-609X |
| DOI | 10.1186/s13054-025-05422-7 |
Cover
| Abstract | Background
Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings.
Methods
BEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission.
Results
The median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113–480). The median ages were 70 (IQR: 59–81) and 72 (IQR: 64–80) years (
P
= 0.77), and 21/40 (53%) and 25/42 (60%) patients were male (
P
= 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24–0.47) and 0.30 (IQR: 0.22–0.34) μg/kg/min in the early and late administration groups, respectively (
P
= 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21–25) and 21 (IQR: 0–24) vasopressor/inotrope-free days (
P
= 0.027), and 18 (IQR: 1–23) and 14 (IQR: 0–19) ICU-free days (
P
= 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13–1.09).
Conclusions
In patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days.
Trial registration
UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302). |
|---|---|
| AbstractList | BackgroundDelayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings.MethodsBEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission.ResultsThe median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113–480). The median ages were 70 (IQR: 59–81) and 72 (IQR: 64–80) years (P = 0.77), and 21/40 (53%) and 25/42 (60%) patients were male (P = 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24–0.47) and 0.30 (IQR: 0.22–0.34) μg/kg/min in the early and late administration groups, respectively (P = 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21–25) and 21 (IQR: 0–24) vasopressor/inotrope-free days (P = 0.027), and 18 (IQR: 1–23) and 14 (IQR: 0–19) ICU-free days (P = 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13–1.09).ConclusionsIn patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days.Trial registration UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302). Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings.BACKGROUNDDelayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings.BEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission.METHODSBEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission.The median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113-480). The median ages were 70 (IQR: 59-81) and 72 (IQR: 64-80) years (P = 0.77), and 21/40 (53%) and 25/42 (60%) patients were male (P = 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24-0.47) and 0.30 (IQR: 0.22-0.34) μg/kg/min in the early and late administration groups, respectively (P = 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21-25) and 21 (IQR: 0-24) vasopressor/inotrope-free days (P = 0.027), and 18 (IQR: 1-23) and 14 (IQR: 0-19) ICU-free days (P = 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13-1.09).RESULTSThe median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113-480). The median ages were 70 (IQR: 59-81) and 72 (IQR: 64-80) years (P = 0.77), and 21/40 (53%) and 25/42 (60%) patients were male (P = 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24-0.47) and 0.30 (IQR: 0.22-0.34) μg/kg/min in the early and late administration groups, respectively (P = 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21-25) and 21 (IQR: 0-24) vasopressor/inotrope-free days (P = 0.027), and 18 (IQR: 1-23) and 14 (IQR: 0-19) ICU-free days (P = 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13-1.09).In patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days. Trial registration UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302).CONCLUSIONSIn patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days. Trial registration UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302). Background Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. Methods BEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission. Results The median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113–480). The median ages were 70 (IQR: 59–81) and 72 (IQR: 64–80) years ( P = 0.77), and 21/40 (53%) and 25/42 (60%) patients were male ( P = 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24–0.47) and 0.30 (IQR: 0.22–0.34) μg/kg/min in the early and late administration groups, respectively ( P = 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21–25) and 21 (IQR: 0–24) vasopressor/inotrope-free days ( P = 0.027), and 18 (IQR: 1–23) and 14 (IQR: 0–19) ICU-free days ( P = 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13–1.09). Conclusions In patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days. Trial registration UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302). Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. BEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine ([greater than or equal to] 0.2 [mu]g/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission. The median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113-480). The median ages were 70 (IQR: 59-81) and 72 (IQR: 64-80) years (P = 0.77), and 21/40 (53%) and 25/42 (60%) patients were male (P = 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24-0.47) and 0.30 (IQR: 0.22-0.34) [mu]g/kg/min in the early and late administration groups, respectively (P = 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21-25) and 21 (IQR: 0-24) vasopressor/inotrope-free days (P = 0.027), and 18 (IQR: 1-23) and 14 (IQR: 0-19) ICU-free days (P = 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13-1.09). In patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days. Background Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. Methods BEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine ([greater than or equal to] 0.2 [mu]g/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission. Results The median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113-480). The median ages were 70 (IQR: 59-81) and 72 (IQR: 64-80) years (P = 0.77), and 21/40 (53%) and 25/42 (60%) patients were male (P = 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24-0.47) and 0.30 (IQR: 0.22-0.34) [mu]g/kg/min in the early and late administration groups, respectively (P = 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21-25) and 21 (IQR: 0-24) vasopressor/inotrope-free days (P = 0.027), and 18 (IQR: 1-23) and 14 (IQR: 0-19) ICU-free days (P = 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13-1.09). Conclusions In patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days. Trial registration UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302). Keywords: Septic shock, Polymyxin B hemoperfusion, Blood purification Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. BEAT-SHOCK (BEst Available Treatment for septic SHOCK) registry is a prospective registry consisting of 309 adult patients with septic shock requiring high-dose norepinephrine (≥ 0.2 μg/kg/min). This predetermined analysis included 82 patients treated with PMX-HP. They were grouped according to the median time from intensive care unit (ICU) admission to administration of PMX-HP: the early administration group (n = 40) and the late administration group (n = 42). The primary outcome was short-term hemodynamic status, including mean arterial pressure and vasoactive-inotropic score (VIS; calculated from doses of dopamine, dobutamine, norepinephrine, epinephrine, vasopressin, milrinone, and levosimendan) within 48 h after ICU admission. The median time from ICU admission to administration of PMX-HP was 265 min (interquartile range [IQR]: 113-480). The median ages were 70 (IQR: 59-81) and 72 (IQR: 64-80) years (P = 0.77), and 21/40 (53%) and 25/42 (60%) patients were male (P = 0.52) in the early and late administration groups, respectively. The dose of norepinephrine at ICU admission was 0.33 (IQR: 0.24-0.47) and 0.30 (IQR: 0.22-0.34) μg/kg/min in the early and late administration groups, respectively (P = 0.17). Within 48 h after ICU admission, mean arterial pressure was significantly higher at 6 h and 8 h, and VIS was significantly lower at 8 h and thereafter in the early administration group. Within a 28-day period, there were 23 (IQR: 21-25) and 21 (IQR: 0-24) vasopressor/inotrope-free days (P = 0.027), and 18 (IQR: 1-23) and 14 (IQR: 0-19) ICU-free days (P = 0.025) in the early and late administration groups, respectively. The cumulative mortality at 90 days was 15.3% in the early administration group and 31.3% in the late administration group (adjusted hazard ratio 0.38; 95% confidence interval 0.13-1.09). In patients with septic shock, early administration of PMX-HP was associated with higher mean arterial pressure and lower VIS within 48 h after ICU admission. Additionally, it may be associated with an improved clinical course, represented by more ICU-free and vasopressor/inotrope-free days. Trial registration UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302). |
| ArticleNumber | 187 |
| Audience | Academic |
| Author | Suzuki, Tsuyoshi Hanajima, Tasuku Okazaki, Tomoya Takahashi, Gaku Miyagawa, Noriko Yamamura, Hitoshi Maruyama, Junichi Miyamoto, Kyohei Kinjo, Masashi Ohta, Yoshinori Toyoda, Yukitoshi Kimura, Takuya Takahashi, Masaki Morimoto, Takeshi Matsuura, Hiroshi Kyo, Michihito Sato, Tetsuya Fukushima, Kazunori Kawazoe, Yu Murata, Satoru Sakurai, Toshihiro |
| Author_xml | – sequence: 1 givenname: Kyohei surname: Miyamoto fullname: Miyamoto, Kyohei email: gomadofu@wakayama-med.ac.jp organization: Department of Emergency and Critical Care Medicine, Wakayama Medical University – sequence: 2 givenname: Yu surname: Kawazoe fullname: Kawazoe, Yu organization: Department of Emergency and Critical Care Medicine, National Hospital Organization Sendai Medical Center – sequence: 3 givenname: Noriko surname: Miyagawa fullname: Miyagawa, Noriko organization: Department of Emergency and Critical Care Medicine, National Hospital Organization Sendai Medical Center – sequence: 4 givenname: Hitoshi surname: Yamamura fullname: Yamamura, Hitoshi organization: Department of Emergency and Critical Care Medicine, Osaka Minato Central Hospital – sequence: 5 givenname: Yoshinori surname: Ohta fullname: Ohta, Yoshinori organization: Department of Emergency and Critical Care Medicine, National Hospital Organization Kyoto Medical Center – sequence: 6 givenname: Takuya surname: Kimura fullname: Kimura, Takuya organization: Department of Emergency Medicine and Critical Care Medicine, Saiseikai Utsunomiya Hospital – sequence: 7 givenname: Yukitoshi surname: Toyoda fullname: Toyoda, Yukitoshi organization: Department of Emergency and Critical Care Medicine, Saiseikai Yokohamashi Tobu Hospital – sequence: 8 givenname: Michihito surname: Kyo fullname: Kyo, Michihito organization: Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Department of Radiation Disaster Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University – sequence: 9 givenname: Tetsuya surname: Sato fullname: Sato, Tetsuya organization: Department of Emergency and Critical Care Medicine, Tohoku University Hospital – sequence: 10 givenname: Masashi surname: Kinjo fullname: Kinjo, Masashi organization: Division of Critical Care Medicine, Nara Prefecture General Medical Center – sequence: 11 givenname: Masaki surname: Takahashi fullname: Takahashi, Masaki organization: Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Hokkaido University – sequence: 12 givenname: Junichi surname: Maruyama fullname: Maruyama, Junichi organization: Department of Emergency Medicine and Critical Care, Fukuoka University Hospital – sequence: 13 givenname: Hiroshi surname: Matsuura fullname: Matsuura, Hiroshi organization: Osaka Prefectural Nakakawachi Emergency and Critical Care Center – sequence: 14 givenname: Kazunori surname: Fukushima fullname: Fukushima, Kazunori organization: Department of Emergency Medicine, Gunma University Graduate School of Medicine – sequence: 15 givenname: Satoru surname: Murata fullname: Murata, Satoru organization: Department of Emergency and Critical Care Medicine, Ehime University Graduate School of Medicine – sequence: 16 givenname: Tomoya surname: Okazaki fullname: Okazaki, Tomoya organization: Emergency Medical Center, Kagawa University Hospital – sequence: 17 givenname: Tsuyoshi surname: Suzuki fullname: Suzuki, Tsuyoshi organization: Department of Emergency and Critical Care Medicine, Fukushima Medical University – sequence: 18 givenname: Toshihiro surname: Sakurai fullname: Sakurai, Toshihiro organization: Department of Emergency and Critical Care Medicine, National Hospital Organization Kumamoto Medical Center – sequence: 19 givenname: Gaku surname: Takahashi fullname: Takahashi, Gaku organization: Department of Critical Care and Disaster Medicine, Iwate Medical University – sequence: 20 givenname: Tasuku surname: Hanajima fullname: Hanajima, Tasuku organization: Trauma and Reconstruction Center, Shin-Yurigaoka General Hospital – sequence: 21 givenname: Takeshi surname: Morimoto fullname: Morimoto, Takeshi organization: Department of Data Science, Hyogo Medical University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40346574$$D View this record in MEDLINE/PubMed |
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| DOI | 10.1186/s13054-025-05422-7 |
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| Keywords | Polymyxin B hemoperfusion Blood purification Septic shock |
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| References | M Singer (5422_CR2) 2016; 315 T Koponen (5422_CR17) 2019; 122 T Tanaka (5422_CR12) 2020; 7 MM Oken (5422_CR20) 1982; 5 N Takeyama (5422_CR11) 2012; 33 AM Higgins (5422_CR22) 2023; 329 M Shankar-Hari (5422_CR1) 2016; 315 T Abe (5422_CR18) 2019; 7 SL Cutuli (5422_CR13) 2016; 6 DN Cruz (5422_CR7) 2009; 301 Y Kawazoe (5422_CR15) 2018; 46 RJ Roberts (5422_CR6) 2020; 48 DT Noritomi (5422_CR4) 2014; 40 WA Knaus (5422_CR19) 1985; 13 JH Lee (5422_CR10) 2024 H Quan (5422_CR21) 2011; 173 MM Levy (5422_CR3) 2018; 46 RP Dellinger (5422_CR8) 2018; 320 AP Houwink (5422_CR5) 2016; 20 S Chihara (5422_CR9) 2017; 20 5422_CR14 K Miyamoto (5422_CR16) 2017; 5 |
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Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings.
Methods... Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. BEAT-SHOCK (BEst... Background Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. Methods... Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings. BEAT-SHOCK (BEst... BackgroundDelayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical... Delayed administration of polymyxin B hemoperfusion (PMX-HP) for septic shock could diminish its efficacy in real-world clinical settings.BACKGROUNDDelayed... |
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| SubjectTerms | Aged Aged, 80 and over Analysis Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Biological research Care and treatment Chronic illnesses Clinical trials Cohort Studies Critical Care Medicine Diagnosis Dopamine Dosage and administration Drug dosages Emergency Medicine Ethics Female Heart failure Hemodynamic monitoring Hemodynamics Hemodynamics - drug effects Hemodynamics - physiology Hemoperfusion - methods Hemoperfusion - standards Human subjects Humans Infections Intensive Intensive Care Units - organization & administration Intensive Care Units - statistics & numerical data Male Medicine Medicine & Public Health Methods Middle Aged Mortality Noradrenaline Norepinephrine - administration & dosage Norepinephrine - pharmacology Norepinephrine - therapeutic use Observational studies Polymyxin B Polymyxin B - administration & dosage Polymyxin B - pharmacology Polymyxin B - therapeutic use Prospective Studies Registries - statistics & numerical data Risk factors Sensitivity analysis Sepsis Septic shock Shock, Septic - drug therapy Shock, Septic - physiopathology Shock, Septic - therapy Time Factors Urogenital system Variables Vasoconstrictor Agents - administration & dosage Vasoconstrictor Agents - therapeutic use |
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| Title | Time to administer polymyxin B hemoperfusion and hemodynamics in patients with septic shock requiring high-dose norepinephrine: a predetermined analysis of a prospective cohort study |
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