{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:56:04Z","timestamp":1787169364680,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polymyxin\u2010B direct hemoperfusion (PMX\u2010DHP) is an endotoxin adsorption column\u2010based blood purification therapy. Since one of the most potent effects of PMX\u2010DHP is blood pressure elevations, it may be the most effective when it is introduced at the time when the need for vasopressors is the greatest, which, in turn, may reduce mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter retrospective study was conducted at 24 ICUs in Japan. In each ICU, the 20 most recent consecutive cases of septic shock treated with PMX\u2010DHP were analyzed. The duration between the time of the peak vasopressive agent dose, expressed as the noradrenaline equivalent dose (NEq), and the time of PMX initiation was evaluated. The primary outcome was 28\u2010day mortality, and a multivariable analysis was performed to investigate factors associated with mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 480 septic shock patients were included in the analysis. Among all patients, the 28\u2010day mortality group was older, more severely ill, and had a higher body mass index. The NEq peak and NEq on PMX\u2010DHP initiation were both higher in deceased patients. Regarding the timing of PMX\u2010DHP initiation from the NEq peak, \u22124\u2009&lt;&lt;\u20094\u2009h had more survivors (229\/304, 75.3%) than \u2264\u22124\u2009h (50\/75, 66.7%) and\u2009\u22654\u2009h (66\/101, 65.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.085). When \u22124\u2009&lt;&lt;\u20094\u2009h was assigned as a reference, the timing of PMX\u2010DHP initiation from the NEq peak of \u2264\u22124\u2009h had an odds ratio of 1.96 (1.07\u20133.58),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029, while \u22654\u2009h had an odds ratio of 1.64 (0.94\u20132.87),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.082 for 28\u2010day mortality, in the multivariable regression analysis. A spline curve of the relationship between the probability of death and the timing of PMX\u2010DHP initiation from the NEq peak showed a downward convex curve with a nadir at timing\u2009=\u20090. The odds ratios of the timing of PMX\u2010DHP initiation other than \u22124\u2009&lt;&lt;\u20094\u2009h were significantly higher in an older age, male sex, lower BMI, more severe illness, and higher oxygenation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The induction of PMX\u2010DHP at the time of the peak vasopressor dose correlated with lower mortality. PMX\u2010DHP is one of the options available for elevating blood pressure in septic shock, and its initiation either too early or late for shock peak may not improve the outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.14865","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T07:29:00Z","timestamp":1726644540000},"page":"218-228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The polymyxin\u2010B direct hemoperfusion\n                    <scp>OPTimal<\/scp>\n                    Initiation timing with Catecholamine\n                    <scp>PMX<\/scp>\n                    \u2010\n                    <scp>OPTIC<\/scp>\n                    study: A multicenter retrospective observational study"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-0294","authenticated-orcid":false,"given":"Kensuke","family":"Nakamura","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine Yokohama City University Hospital  Yokohama Kanagawa Japan"},{"name":"Department of Emergency and Critical Care Medicine Hitachi General Hospital  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Kyoto Okamoto Memorial Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihito","family":"Tampo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Asahikawa Medical University  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Mochizuki","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Hitachi General Hospital  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine University of Tsukuba Hospital  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunio","family":"Yanagita","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Tokyo Medical University Ibaraki Medical Center  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Shimomura","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Japanese Red Cross Osaka Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taichi","family":"Murase","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Ijinkai Takeda General Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering, Medical Corporation Tokushukai Uji Tokushukai Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences Okayama University  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Kokura Memorial Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering National Cerebral and Cardiovascular Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Nara Prefecture Seiwa Medical Center  Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Toyooka Public Hospital  Toyooka Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Morishima","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Akashi Medical Center  Akashi Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuma","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Fukuoka Wajiro Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroharu","family":"Yasui","sequence":"additional","affiliation":[{"name":"Department Medical Engineer Center Matsue City Hospital  Matsue Shimane Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Akashi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Hitachi General Hospital  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kojiro","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department Blood Purification National Defence Medical College Hospital  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroo","family":"Kawarazaki","sequence":"additional","affiliation":[{"name":"Department of the Fourth Internal Medicine Teikyo University Mizonokuchi Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsukasa","family":"Akiba","sequence":"additional","affiliation":[{"name":"Department Clinical Engineering Tsuchiura Kyodo General Hospital  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susumu","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Nikko Memorial Hospital  Muroran Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhei","family":"Honma","sequence":"additional","affiliation":[{"name":"Division of Clinical Engineering Asahikawa Medical University Hospital  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Shinshu University School of Medicine  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Rheumatology and Endocrinology Tohoku University Graduate School of Medicine  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Takaki","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Yokohama City University Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Clinical Engineering Nanpuh Hospital  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chizuru","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Fujita Health University School of Medicine  Toyoake Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526\u20100968.2003.00005.x"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010015\u20103751\u2010z"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.14618"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010018\u20105463\u20107"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010023\u201004533\u20103"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc5780"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010307"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2012.12.042"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201034084\u20100"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010019\u201005801\u2010z"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc8167"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10047\u2010016\u20100922\u20109"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.446"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246\u2010199601000\u201000026"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0288"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560\u2010024\u201000733\u20103"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704154"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.18926\/AMO\/31855"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000287232"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001476"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0014\u20105793(00)01313\u20102"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540\u2010005\u20100366\u20105"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2016.05.004"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330325"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010015\u20100069\u20105"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560\u2010017\u20100215\u20102"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.02.014"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000063045.77339.B6"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000002282"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744\u20109987.1998.tb00066.x"},{"key":"e_1_2_15_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489920"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.14865","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T02:39:58Z","timestamp":1739241598000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.14865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/aor.14865"],"URL":"https:\/\/doi.org\/10.1111\/aor.14865","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,18]]},"assertion":[{"value":"2024-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}