naa a22 4500 510814131 CHVBK 20180411083456.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s12328-013-0411-0 doi (NATIONALLICENCE)springer-10.1007/s12328-013-0411-0 Endotoxin adsorption therapy using polymyxin B-immobilized fiber as a treatment for septic shock-associated severe acute cholangitis [Elektronische Daten] [Yoshihiro Inoue, Yasuhisa Fujino, Makoto Onodera, Satoshi Kikuchi, Gaku Takahashi, Masahiro Kojika, Shigeatsu Endo] Abstract : The application of endotoxin adsorption therapy for severe acute cholangitis is controversial. We present a survival case of septic shock and multiple organ failure due to severe acute cholangitis. The patient was treated by endotoxin adsorption therapy using polymyxin B-immobilized fiber because he continued to remain in shock even after successful endoscopic nasobiliary drainage. The patient was an 84-year-old male diagnosed with acute cholangitis and acute pancreatitis who was transferred to our department because of shock and severe dyspnea. The patient had already developed acute respiratory failure, acute renal failure, and disseminated intravascular coagulation. We performed endoscopic nasobiliary drainage immediately, but the patient continued to remain in shock and plasma endotoxin level was markedly elevated at 133.6pg/mL. Therefore, we performed direct hemoperfusion with polymyxin B-immobilized fiber. On starting the hemoperfusion, blood pressure and urine volume increased, and the plasma endotoxin level reduced considerably. On the basis of our experience in this case, we think that direct hemoperfusion with polymyxin B-immobilized fiber may be a useful modality in the management of severe acute cholangitis. Springer Japan, 2013 Cholangitis nationallicence Septic shock nationallicence Endotoxin nationallicence Multiple organ failure nationallicence Polymyxin B nationallicence Inoue Yoshihiro Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut Fujino Yasuhisa Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut Onodera Makoto Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut Kikuchi Satoshi Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut Takahashi Gaku Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut Kojika Masahiro Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut Endo Shigeatsu Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut Clinical Journal of Gastroenterology Springer Japan 6/5(2013-10-01), 390-394 1865-7257 6:5<390 2013 6 12328 https://doi.org/10.1007/s12328-013-0411-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12328-013-0411-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Inoue Yoshihiro Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut NATIONALLICENCE 700 1- Fujino Yasuhisa Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut NATIONALLICENCE 700 1- Onodera Makoto Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut NATIONALLICENCE 700 1- Kikuchi Satoshi Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut NATIONALLICENCE 700 1- Takahashi Gaku Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut NATIONALLICENCE 700 1- Kojika Masahiro Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut NATIONALLICENCE 700 1- Endo Shigeatsu Department of Critical Care Medicine, Iwate Medical University, 19-1 Uchimaru, 020-8505, Morioka, Iwate, Japan aut NATIONALLICENCE 773 0- Clinical Journal of Gastroenterology Springer Japan 6/5(2013-10-01), 390-394 1865-7257 6:5<390 2013 6 12328 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer