Polymyxin B hemoperfusion therapy was an important theme at the recent 71st National Congress of Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI), held in Rimini on October 18 – 21, 2017.
The symposium entitled “Precision therapy in endotoxic septic shock” on October 19, with lectures and debates by Prof. Forfori, Prof. Antonelli (President of ESICM), Prof. Fumagalli and Prof. Grasso had great attendance and interaction from the audience. The message from this session was clear: Polymyxin B hemoperfusion therapy is a reference adjunctive “precision therapy” in the treatment of patients with endotoxic septic shock.
Interesting abstracts were presented, in particular:
- Use of Polymyxin B hemoperfusion for acute amiodarone pulmonary toxicity. A case report (Caria FC, Agostini M. et al. – Montebelluna)
Amiodarone pulmonary toxicity (APT) is the most serious side effect of amiodarone, a drug used to treat arythmics. The authors describe the successful treatment of a patient with APT, using Polymyxin B hemoperfusion.
- Use of Polymyxin B direct hemoperfusion in meningococcal sepsis. A case report (Viola G., Fraganza F. – Napoli)
Meningococcal sepsis carries a high mortality risk. The authors describe the successful use of Polymyxin B hemoperfusion in a patient with meningococcal sepsis.
The role of adsorption was discussed at the 58th National Congress of the Italian Society of Nephrology (SIN) held in Rimini, Italy, 4 – 7 October 2017.
The symposium entitled BLOOD PURIFICATION THERAPIES e ruolo clinico dell’adsorbimento, with lectures by Prof. Grandaliano, Prof. Cantaluppi and Prof. Ronco was very well attended.
Concerning chronic kidney disease (CKD), it is well known that end stage renal disease is associated with immune dysfunction (immunosuppression and immune activation), which may have various consequences such as cardiovascular disease, acute and chronic recurrent infections, neoplasia and low response rate to HBV vaccination.
Recent results were presented, demonstrating the role of PMMA in positively affecting the immune response and correlated mortality risk in HD patients.
The “immune-protective” role of the PMMA membrane makes it reasonable to consider PMMA adsorptive hemodialysis as a basic strategy for treatment of HD patients waiting for renal transplantation.
Preliminary and novel data concerning an on-going clinical study on the potential role of the PMMA membrane in removing sCD40L were presented; these results were very encouraging and enhance the role of PMMA as a cardiovascular protector.
Regarding Polymyxin B hemoperfusion therapy, prof. Ronco illustrated the state-of-the art of “precision therapy”, describing this therapy as a reference for the treatment of unresponsive septic shock.