Skip to main content
  • Poster presentation
  • Open access
  • Published:

Alteco endotoxin hemoadsorption in Gram-negative septic shock patients


Septic shock is a common cause of mortality and morbidity in the ICU. Endotoxin hemoadsorption using a Polymyxin B fiber column can improve patient outcome [1]. This study investigated the therapeutic effect of a new endotoxin hemoadsorption device in Gram-negative septic shock patients.


An open, controlled, prospective, randomized, single-centre trial conducted between February 2010 and June 2012. Patients with septic shock due to intra-abdominal sepsis were recruited and randomized to either standard therapy (ST, n = 8) or standard therapy plus two 2 hourly sessions of Alteco endotoxin hemoperfusion (AT, n = 7). Standard therapy included infective source control, appropriate early antibiotic, low-dose steroid, early continuous renal replacement therapy in the presence of acute kidney injury (RIFLE Injury class or more), hemodynamic optimization and lung-protected ventilatory support. Primary outcome was change in organ dysfunction at 48 hours measured by Sequential Organ Failure Assessment (SOFA) scores. Secondary outcomes were change in vasopressor requirement (measured by vasopressor score), PaO2/FiO2 (fraction of inspired oxygen) ratio, total urine output at 72 hours and 28-day mortality.


This study was terminated early as interim analysis identified no significant clinical benefit. Baseline characteristics (age/APACHE IV score) were similar between two groups of patients. No significant difference was noted between two groups with respect to change in total SOFA score (+1 vs. -5.5 for AT vs. ST, P = 0.382), vasopressor score (-29 vs. -46.6, 3= 0.775), PaO2/FiO2 P ratio (-26 vs. +163, P = 0.199), total urine output from 0 to 72 hours (3,850 ml vs. 4,570 ml, P = 0.355) and 28-day mortality (14.3% vs. 37.5%, P = 0.569). No significant side effect was noted when using this new hemoadsorption device.


This small study cannot identify any extra clinical benefit on addition of Alteco endotoxin hemoadsorption to standard therapy in patients suffering from intra-abdominal sepsis with shock due to Gram-negative bacterial infection.


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

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


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 The Creative Commons Public Domain Dedication waiver ( 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

Shum, H., Chan, K. & Yan, W. Alteco endotoxin hemoadsorption in Gram-negative septic shock patients. Crit Care 17 (Suppl 2), P68 (2013).

Download citation

  • Published:

  • DOI: