Newly developed immobilized polymyxin B fibers improve the survival of patients with sepsis

Background. Sepsis and septic shock are still major causes of morbidity and mortality in spite of the availability of powerful and broadly active anti biotics. Methods: A prospective, open and randomized trial of the effect of immobilized polymyxin fibers (PMX-F) on the survival of patients with seps is throughout a follow-up period of 28 days or until discharge, if earlier, was carried out. Ninety-eight patients were included who met at least 4 of the criteria for systemic inflammatory response syndrome due to infection. The patients were classified into three groups based on their Acute Physio logy and Chronic Health Evaluation (APACHE) II score. Results: The overall survival rate was significantly improved by using PMX-F compared to the con trol group (41 vs. 11%) (p = 0.002). In patients with an APACHE II score le ss than 20, treatment with PMX-F was shown to improve outcome (65 vs. 19%) (p = 0.01). In cases of more severe sepsis with an APACHE II score of 20-29 , PMX-F still maintained efficacy in improving outcome (40 vs. 11%) (p = 0. 04). However, PMX-F treatment did not improve the survival rate in patients with an APACHE II score of greater than 30 (survival rate 7 vs. 0%) (p=0.5 9). Conclusion: From these results, it is concluded that treatment with PMX -F in patients with sepsis is effective and prolongs the survival rate when applied at an early stage of sepsis. However, in severe sepsis, this thera py does not improve the survival rate. Copyright (C) 2001 S. Karger AG, Bas el.