Polymyxin B Hemoperfusion and Mortality in Abdominal Septic Shock
- Yujiro Kida, MD, PhDResearch Center for Liver DiseasesKeck School of MedicineUniversity of Southern CaliforniaLos Angeles
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ABDOMEN
- CRITICAL CARE
- DATA INTERPRETATION, STATISTICAL
- DRUG THERAPY
- ENDOTOXINS
- HEMOPERFUSION
- POLYMYXIN B
- SEPSIS
- SHOCK, SEPTIC
To the Editor: Dr Cruz and colleagues1 concluded that polymyxin B hemoperfusion added to conventional therapy reduced 28-day mortality in patients with severe sepsis or septic shock from intra-abdominal gram-negative infections. However, Table 2 in their article showed that gram-positive bacteria such as Enterococcus, Staphylococcus, and Streptococcus were more frequently isolated in the polymyxin B hemoperfusion group than the conventional therapy group. Therefore, the frequencies of gram-negative sepsis and severe endotoxemia seemed to be high in the conventional therapy group compared with the polymyxin B hemoperfusion group.
Such imbalance in the characteristics of the treatment groups could affect the study conclusion. Since the authors did not measure the level of endotoxin, it is unclear whether removal of endotoxin directly improved the survival ratio of polymyxin B hemoperfusion group.
Financial Disclosures: None reported.
Letters Section Editor: Robert M. Golub, MD, Senior Editor.
