Urosepsisによる敗血症性ショックに対して血中エンドトキシン吸着療法を行った3例

Abstract

78歳男, 75歳男, 68歳男.Urosepsisによる敗血症性ショックに対して, エンドトキシン吸着を行い軽快した3症例を報告した.エンドトキシン吸着は循環動態の改善に有効であり, SIRSの段階で試みる価値があると思われた

Clinical experiences of endotoxin removal using polymyxin B immobilized fiber column (PMX) in three septic shock patients are reported. The patients were referred to our hospital with complaints of high fever and severe pain during urination. Physical examination and laboratory data revealed severe hypotension, tachycardia, and pyuria. Diagnoses of septic shock due to urosepsis were made. After antibiotic therapy and anti-shock therapy, direct hemoperfusion using polymyxin B immobilized fiber column (PMX) was carried out. Thereafter, cardiovascular instabilities were improved without increasing the supply of catecholamines. PMX therapy for systemic inflammatory response due to infection was effective in treatment of cardiovascular instabilities.