Endotoxin removal by hemoperfusion in septic shock

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The effect of endotoxin adsorber hemoperfusion on microcirculation in patients with severe sepsis and septic shock

Introduction Microcirculatory dysfunction may result in multiple organ dysfunction during severe sepsis and septic shock. (1) A meta-analysis of randomized trials showed that polymyxin B hemoperfusion (PMX-HP), plasma exchange, and hemofiltration were associated with lower mortality. (2) Mesenteric microcirculation was better maintained with polymyxin B hemoperfusion in one rat sepsis study. (3...

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Polymyxin B-immobilized fiber column hemoperfusion therapy for septic shock.

Endotoxin, an outer membrane component of gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin adsorption therapy by polymyxin B-immobilized fiber column hemoperfusion (PMX) has been used for the treatment of septic shock patients in Japan since 1994. The covalent binding of polymyxin B onto the surface of the polystyrene-based carrier fiber in PMX inac...

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Polymyxin B Hemoperfusion for Septic Shock -- Ready for Primetime? Early Use of Polymyxin B Hemoperfusion in Abdominal Septic Shock: The EUPHAS Randomized Controlled Trial

Background: Treatments for severe sepsis are limited, and its morbidity and mortality, especially from Gramnegative organisms, continues to be significant. Gram-negative organisms release endotoxin, which initiates inflammatory and coagulation cascades, resulting in end-organ dysfunction in patients. Polymyxin B hemoperfusion filters bind endotoxin. Objective: To assess the efficacy of polymyxi...

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Endotoxin in newborn septic shock: significance, metabolic, and cardiovascular changes.

The role of endotoxin in newborn septic shock is reviewed. Metabolic and cardiovascular changes, as known to us, are described with special emphasis that the newborn is not a "small adult." Developmental or maturational changes are hypothesized to be the major cause of these differences between age groups. Finally, it is our belief that newborn septic shock is an important topic for further inv...

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A new endotoxin adsorber in septic shock: observational case series.

AIMS Effects of a new endotoxin adsorber on the length of noradrenaline (NA) treatment, LPS (lipopolysaccharide) levels and SOFA (sequential organ failure assessment) scores in septic shock were evaluated. METHODS Two-hour hemoperfusion with LPS adsorber was initiated in patients with septic shock and endotoxemia. Controls were matched for age, focus and severity of illness. RESULTS Adsorpt...

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ژورنال

عنوان ژورنال: Critical Care

سال: 2011

ISSN: 1364-8535

DOI: 10.1186/cc10376