Volume 2 Supplement 1

18th International Symposium on Intensive Care and Emergency Medicine

Open Access

Pentoxifylline in severe sepsis: a double-blind, randomized placebo-controlled study

  • KH Staubach1,
  • J Schröder1,
  • P Zabel1 and
  • F Stüber1
Critical Care19982(Suppl 1):P017

https://doi.org/10.1186/cc147

Published: 1 March 1998

Full text

Pentoxifylline (POF) inhibits macrophage production of tumor necrosis factor alpha (TNF) as a central mediator in sepsis. To evaluate the therapeutic effect of POF in patients with sepsis a prospective, double-blind, placebo-controlled study in two centers (Lübeck, Kiel) was performed. 51 patients were included and randomized to receive POF continuously (1 mg/kg bw/h i.v.) or saline solution as placebo over 28 days maximally or until patients were discharged from ICU or died. Bioactivity of TNF and interleukin (IL)-6, MOF-score according to Goris as well as organ function were determined at diagnosis, daily from day 1 to 7, on day 10, 14, 17, 21, 24 and 28 after diagnosis of sepsis. There were no differences in patients characteristics at diagnosis concerning APACHE II score [17 ± 4 (mean ± SD)] for POF and 18 ± 5 points for placebo), MOF-score (10.5 vs 10.7) or organ function. At study entrance 23 of 27 patients in the POF-group and 21/24 in the placebo-group had septic shock. No adverse effects of POF-treatment were observed. The 28 day mortality rate was 30% (8/27) in POF treated patients and 33% (8/24) in the control group. Hospital mortality was 41% (11/27) and 54% (13/24). Serum concentrations of TNF and IL-6 were not significantly different throughout the evaluation. MOF-score was lower in POF treated patients after day 4 compared to placebo treated patients which reached significant differences on day 14 and 21 (P < 0.05, unpaired t-test). PaO2/FioO2-ratio was significantly improved in POF treated patients from day 10 (266 ± 132) to day 21 (346 ± 142) compared to the placebo group (201 ± 161 vs 221 ± 112, P < 0.05 and P < 0.01 on day 14 and 17). Pressure-adjusted heart rate (HR×CVP/MAP) was significantly improved from day 6 to day 10 (P < 0.05) in patients treated with POF compared to the control group. A multi-center trial is needed to evaluate the efficacy in improving organ function and outcome in severe sepsis.

Authors’ Affiliations

(1)
Dept. of Surgery, Medical University of Lübeck and Kiel, Forschungszentrum Borstel

Copyright

© Current Science Ltd 1998

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