Tomoharu Shimizu b , Kazuyoshi Hanasawa b , Tohru Tani b , Yoshihiro Endo b , Yoshimasa Kurumi b , Toshiaki Ikeda a,c , Naohiro Fujita a,d , Hiroyuki Morita a,e , Hitoshi Imaizumi a,f , Takashi Sato a,g , Hiroshi Katayama a,h
05 June 2003
Background/Aims: This study evaluated the mechanism of hemodynamic improvement in polymyxin B-immobilized fiber (PMX) treatment. Methods: Fifteen septic patients with endotoxemia and/or gram negative infection were treated with PMX. Plasma concentrations of calcitonin gene-related peptide (CGRP) and nitric oxide metabolites were measured. Results: CGRP and nitric oxide metabolites before treatment were significantly higher than in healthy controls. CGRP had a significantly inverse correlation with diastolic blood pressure and a positive correlation with the Septic Severity Score and the number of failed organs. Systolic and diastolic blood pressure and systemic vascular resistance index increased significantly both immediately after and 24 h after PMX treatment. CGRP decreased significantly 24 h after the treatment. In contrast, there were no significant changes in nitric oxide metabolites. Conclusion: PMX treatment improved hemodynamic parameters in septic patients, and CGRP increased with increasing severity of sepsis. We conclude that a decrease in CGRP levels may be related to hemodynamic improvement resulting from PMX treatments.