Introduction
For septic shock, especially that caused by infection with Gram-negative bacteria, endotoxin adsorption (direct hemoperfusion using polymyxin B fixed fiber: PMX-DHP) is regarded as an effective method of treatment in Japan. In 27 patients who were admitted to ICU and underwent PMX-DHP for severe sepsis or septic shock, the kinetics of PAI-1 were determined, and compared between the group with a high endotoxin level of 10 pg/ml or more just before the initiation of PMX-DHP and the group with a normal endotoxin level of less than 10 pg/ml. Furthermore, the relations between PAI-1 and other mediators were examined.