DOI: 10.1002/1744-9987.70210 ISSN: 1744-9979

Incidence and Clinical Outcomes of Circuit Clotting During Prolonged Polymyxin B Hemoperfusion in Patients With Septic Shock: A Post Hoc Analysis of a Prospective Cohort Study

Kyohei Miyamoto, Yu Kawazoe, Takeshi Morimoto, Hitoshi Yamamura, Noriko Miyagawa, Yoshinori Ohta, Mami Shibata, Nozomu Shima, Tsuyoshi Nakashima, Shigeaki Inoue
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ABSTRACT

Introduction

Circuit clotting during polymyxin B hemoperfusion ( PMX ‐ HP ) therapy could be associated with poor clinical outcomes in patients with septic shock.

Methods

This post hoc sub‐analysis of the BEAT ‐ SHOCK registry included 82 of 309 adults with septic shock requiring high‐dose norepinephrine (≥ 0.2 μg/kg/min) that underwent PMX ‐ HP therapy. We compared 28‐day mortality between patients with and without circuit clotting during the first session.

Results

Among 82 patients (median PMX ‐ HP duration, 1016 min), 25 patients (30%) had premature termination due to circuit clotting of those patients, 28‐day mortality was 16% (4/25), as compared with 18% (10/57) in those without circuit clotting (adjusted hazard ratio 0.58; 95% confidence interval 0.13–2.55). Lower serum albumin was associated with circuit clotting (adjusted hazard ratio 0.48; 95% confidence interval 0.27–0.85; per 1 g/ dL increase).

Conclusions

Circuit clotting occurred in one‐third of patients but was not associated with poorer outcomes.

Trial Registration: UMIN Clinical Trial Registry, registration no. UMIN000038302

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