Skip to main content

Selective adsorption of lipopolysaccharide in the complex treatment of patients with severe sepsis

Introduction

Severe sepsis and septic shock remain the most serious problem of critical care medicine with a mortality rate of 30 to 55% [1]. 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.

Methods

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.

Table 1 Clinical characteristics of the groups

Results

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.

Conclusion

The use of the LPS-selective adsorption (particularly PMX-F) in patients with severe sepsis leads to improvement of systemic inflammation and organ dysfunction.

References

  1. 1.

    Vincent JL, et al.: Crit Care Med. 2006, 34: 344-353. 10.1097/01.CCM.0000194725.48928.3A

    Article  PubMed  Google Scholar 

  2. 2.

    Cruz DN, et al.: JAMA. 2009, 301: 2445-2452. 10.1001/jama.2009.856

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Yaroustovsky M, et al.: Blood Purif. 2009, 28: 227-233. 10.1159/000231988

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to S Rei.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

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, P67 (2013). https://doi.org/10.1186/cc12005

Download citation

Keywords

  • Mortality Rate
  • Septic Shock
  • Emergency Medicine
  • Postoperative Period
  • Severe Sepsis