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

Abstract

Objective: To clarify whether plasma concentrations of soluble P-selectin, platelet factor-4 (PF-4) and β-thromboglobulin (βTG) are altered in patients with septic shock and whether polymyxin B-immobilized fiber (PMX-F) treatment affects these changes.¶Subjects: Thirty patients with septic shock who were treated with PMX-F (group A), 20 such patients who received conventional therapies (group B) and 20 healthy control subjects (group C).¶Methods: ELISA using commercial kits. Endotoxin elimination by direct hemoperfusion using PMX-F.¶Results: Blood endotoxin levels decreased significantly from 49.4 ± 8.8 pg/ml to 13.0 ± 4.5 pg/ml after PMX-F treatment. The pretreatment plasma concentrations of soluble P-selectin, PF-4 and βTG in patients in groups A and B were significantly higher than those in group C (p < 0.001). Plasma concentrations of these factors decreased significantly in group A after PMX-F treatment (p < 0.01); however, the concentrations in group B were not altered after conventional treatment. The survival rate of group A (60%) was higher than that of group B (30%).¶Conclusions: Our 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 septic shock.