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2009 Aug 14 – Preliminary Report regarding the Use of Selective Sorbents in Complex Cardiac Surgery Patients with Extensive Sepsis and Prolonged Intensive Care Stay

M. Yaroustovsky, M. Abramyan, Z. Popok, E. Nazarova, O. Stupchenko, D. Popov, M. Plushch, N. Samsonova. Blood Purif 2009;28:227-233 

Fig. The Alteco lipopolysaccharide adsorber used in Intensive Care Unit, Pamela Youde Nethersole Eastern Hospital, Hong Kong, for abdominal sepsis (Click image to enlarge)
Aims: The purpose of this publication is to evaluate the first experiences with the supplemental use of selective endotoxin adsorption cartridges in the treatment of critically ill patients complicated by severe sepsis after cardiac surgery. Methods: Thirteen patients with Gram-negative sepsis underwent the procedure of selective lipopolysaccharide (LPS) adsorption using Alteco adsorber (group I) or Toraymyxin columns (polymyxin-B-immobilized fiber) (group II).

Results: This therapy positively influenced the course of sepsis. After the second procedure, levels of serum endotoxin and procalcitonin markedly decreased in both groups. We also discovered a positive effect on leukocytosis levels and a trend towards normalization of body temperature, improvement of hemodynamic indices and increase of the lung’s oxygenating function. Blood cultures taken several days after the procedure were negative. Conclusion: Our experience with LPS adsorption shows some evidence for the potential efficacy of this method in the treatment of critically ill patients with sepsis. Further investigations are required.

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