Effects of prolonged direct hemoperfusion using a polymyxin B immobilized fiber cartridge on interleukin-6 concentration in patients with septic shock: a prospective exploratory trial

Abstract Background The aim of this study was to evaluate the effect of prolonged direct hemoperfusion using polymyxin B immobilized fiber cartridges (PMX-DHP) on interleukin-6 (IL-6) concentration in patients with septic shock. Methods A total of 16 patients received a total of 26 sessions of 12-h PMX-DHP (PMX-DHP-12h group) and 7 patients received a total of 11 sessions of 2-h PMX-DHP (PMX-DHP-2h group). We compared serum IL-6 concentrations and other secondary outcomes between the two treatment groups. IL-6 concentrations were measured at 0, 2, 5, 8, and 12 h. Results The median age was 78 years (interquartile range [IQR] 60–84) in PMX-DHP-12h group and 75 years (IQR 66–81) in PMX-DHP-2h group (P = 0.92). The median acute physiology and chronic health evaluation II score was 23 (IQR 18–31) in the PMX-DHP-12h group and 21 (IQR 17–28) in the PMX-DHP-2h group (P = 0.64). A major source of infection in both groups was the abdomen. The serum IL-6 concentrations in both groups significantly decreased at each time point after 0 h (P < 0.05). However, the decrease in IL-6 concentration did not differ between the groups (P = 0.92). In-hospital mortality was not significantly different in the PMX-DHP-12h group vs. PMX-DHP-2h group (7 patients [44%] vs. 1 patient [14%]; P = 0.35). Conclusions We could not confirm the additional effect that 12 h of PMX-DHP had on the reduction in serum IL-6 concentrations over that exerted by 2 h of this regimen. Trial registration UMIN-CTR, UMIN000016654 . Registered 3 March 2015