Selective adsorption of lipopolysaccharide in the complex treatment of patients with severe sepsis
Critical Care volume 17, Article number: P67 (2013)
Severe sepsis and septic shock remain the most serious problem of critical care medicine with a mortality rate of 30 to 55% . Several studies have demonstrated positive effects of selective adsorption of LPS on blood pressure, PaO2/FiO2 ratio, endotoxin removal and mortality [2, 3]. The purpose of the study was to evaluate the efficiency of using the selective adsorption of LPS, Toraymyxin - PMX-F (Toray, Japan) and Alteco® LPS Adsorber (Alteco Medical AB, Sweden), in the complex treatment of patients with severe sepsis.
Forty-six patients with Gram-negative sepsis in the postoperative period were enrolled into the study. Toraymyxin - PMX-F was used in the PMX-F group (n = 14), while Alteco LPS adsorption was used in the Alteco LPS group (n = 32). The clinical characteristics are listed in Table 1. The SOFA score, PaO2/FiO2, procalcitonin (PCT), C-reactive protein (CRP), endotoxin activity assay (EAA) was noted before, 24 and 48 hours after the selective adsorption of LPS.
At 48 hours after PMX-F, significantly decreased PCT from 17.5 (5.0; 40.9) to 7.1 (4.8; 13.0) ng/ml, P = 0.028, decreased CRP from 180 (133; 286) to 132 (68; 155) mg/l, P = 0.015 and SOFA score from 7.0 (3,0; 8.0) to 6.0 (3,0; 7.0), P = 0.007. At 24 hours after Alteco LPS, significantly decreased PCT from 8.7 (3.0; 25.9) to 4.8 (2.1; 10.0) ng/ml. The 28-day mortality rate was 14.2% (n = 2) in the PMX-F group and 31.3% (n = 10) in the Alteco LPS group.
The use of the LPS-selective adsorption (particularly PMX-F) in patients with severe sepsis leads to improvement of systemic inflammation and organ dysfunction.
Vincent JL, et al.: Crit Care Med. 2006, 34: 344-353. 10.1097/01.CCM.0000194725.48928.3A
Cruz DN, et al.: JAMA. 2009, 301: 2445-2452. 10.1001/jama.2009.856
Yaroustovsky M, et al.: Blood Purif. 2009, 28: 227-233. 10.1159/000231988
About this article
Cite this article
Rei, S., Aleksandrova, I., Kiselev, V. et al. Selective adsorption of lipopolysaccharide in the complex treatment of patients with severe sepsis. Crit Care 17 (Suppl 2), P67 (2013). https://doi.org/10.1186/cc12005
- Mortality Rate
- Septic Shock
- Emergency Medicine
- Postoperative Period
- Severe Sepsis