{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:53:48Z","timestamp":1787165628848,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004420","name":"Wakayama Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004420","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016770","name":"Iwate Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016770","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prolonged duration of polymyxin B hemoperfusion (PMX\u2010HP) for septic shock is not widely investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used BEAT\u2010SHOCK, a prospective registry including 309 adult patients with septic shock requiring high\u2010dose norepinephrine (\u2265\u20090.2\u2009\u03bcg\/kg\/min). Our post hoc analysis included 82 patients that underwent PMX\u2010HP, dichotomized into either the ultra\u2010long PMX\u2010HP group (first session duration \u2265\u200912\u2009h;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200953) or the non\u2010ultra\u2010long PMX\u2010HP group (&lt;\u200912\u2009h;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929). The primary outcomes were changes in vasopressor\/inotrope dosage, represented by vasoactive\u2010inotropic score (VIS), and sequential organ failure assessment (SOFA) score from baseline to day 3.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median durations of the first PMX\u2010HP session in the ultra\u2010long and non\u2010ultra\u2010long PMX\u2010HP groups were 1290 and 358\u2009min, respectively. Their median baseline VIS was 38.3 (IQR 26.0\u201349.5) in the ultra\u2010long group, 38.1 (IQR 30.9\u201355.6) in the non\u2010ultra\u2010long PMX\u2010HP group. The median baseline SOFA score was 11 (IQR 9\u201313) in both groups. The changes in these scores from baseline to day 3 did not differ between them (adjusted difference \u22123.8 [95% confidence interval \u22129.0 to 11.3] for VIS and \u22120.0 [95% confidence interval \u22121.5 to 1.5] for SOFA score). The 90\u2010day mortality rate was 24.7% in the ultra\u2010long PMX\u2010HP group and 21.1% in the non\u2010ultra\u2010long PMX\u2010HP group (adjusted hazard ratio 1.35; 95% confidence interval 0.49\u20133.69).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ultra\u2010prolonged PMX\u2010HP for \u2265\u200912\u2009h was not associated with a greater reduction in vasopressor\/inotrope dosage or improvement in organ dysfunction on day 3 than PMX\u2010HP &lt;\u200912\u2009h in our patients with septic shock without endotoxin monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>UMIN Clinical Trial Registry on 1 November 2019 (registration no. UMIN000038302)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70025","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:25:11Z","timestamp":1760012711000},"page":"458-467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultra\u2010Long Polymyxin B Hemoperfusion and Its Effect on Vasopressor Dosage and Organ Dysfunction in Patients With Septic Shock Requiring High\u2010Dose Norepinephrine: A Post Hoc Analysis of a Prospective Cohort Study"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-2731","authenticated-orcid":false,"given":"Kyohei","family":"Miyamoto","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Kawazoe","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine National Hospital Organization Sendai Medical Center  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Miyagawa","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine National Hospital Organization Sendai Medical Center  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Yamamura","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Osaka Minato Central Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Ohta","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine National Hospital Organization Kyoto Medical Center  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Critical Care Medicine Saiseikai Utsunomiya Hospital  Utsunomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukitoshi","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Hiratsuka City Hospital  Hiratsuka Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihito","family":"Kyo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"},{"name":"Department of Radiation Disaster Medicine, Research Institute for Radiation Biology and Medicine Hiroshima University  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1373-5810","authenticated-orcid":false,"given":"Tetsuya","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Tohoku University Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kinjo","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine Nara Prefecture General Medical Center  Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3615-2132","authenticated-orcid":false,"given":"Masaki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine Hokkaido University Faculty of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Critical Care Fukuoka University Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Osaka Prefectural Nakakawachi Emergency and Critical Care Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Gunma University Graduate School of Medicine  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Data Science Hyogo Medical University  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"BEAT\u2010SHOCK Registry Investigator","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.14618"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1705835"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc13912"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.856"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744\u20109987.1998.tb00066.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010016\u20100178\u20109"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000489920"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000491744"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560\u2010017\u20100214\u20103"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14865"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2014.03.031"},{"key":"e_1_2_12_14_1","unstructured":"Japan MoHLW \u201cEthical Guidelines for Medical and Biological Research Involving Human Subjects \u201daccessed August 13 2024 https:\/\/www.mhlw.go.jp\/content\/001077424.pdf."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000320128"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000515685"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.12.019"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560\u2010019\u20100383\u20103"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-198212000-00014"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000488639"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.70025","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aor.70025","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.70025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T06:32:47Z","timestamp":1776493967000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.70025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/aor.70025"],"URL":"https:\/\/doi.org\/10.1111\/aor.70025","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}