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Endotoxemia and Endotoxin Shock

Disease, Diagnosis and Therapy

Editor(s): Ronco C. (Vicenza) 
Piccinni P. (Vicenza) 
Rosner M.H. (Charlottesville, Va.) 
Cover

Endotoxin Removal in Septic Shock in Clinical Settings

Early Management of Endotoxemia Using the Endotoxin Activity Assay and Polymyxin B-Based Hemoperfusion

Novelli G.a · Ferretti G.b · Ruberto F.c · Morabito V.a · Pugliese F.c

Author affiliations

aDipartimento ‘P. Stefanini’ Chirurgia Generale e Trapianti d’Organo, bDipartimento di Malattie Infettive e Tropicali, cDipartimento di Scienza Anestesiologiche, Medicina Critica e del Dolore, La Sapienza Università di Roma, Rome, Italy

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Ronco C, Piccinni P, Rosner MH (eds): Endotoxemia and Endotoxin Shock: Disease, Diagnosis and Therapy. Contrib Nephrol. Basel, Karger, 2010, vol 167, pp 91–101

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Article / Publication Details

First-Page Preview
Abstract of Endotoxin Removal in Septic Shock in Clinical Settings

Published online: June 01, 2010
Cover Date: 2010

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0

ISBN: 978-3-8055-9484-4 (Print)
eISBN: 978-3-8055-9485-1 (Online)

Abstract

Background: We evaluated the ability of the endotoxin activity (EA) assay to determine the need for early intervention for endotoxemia using polymyxin B-based hemoperfusion (PMX-DHP) on septic patients. Methods: Twenty-four patients were enrolled. Eleven patients had a high EA level (≥0.6) and were treated with PMX-DHP every 24 h until the EA level was low ( < 0.4). The remaining 13 patients had EA levels < 0.60 and received standard therapy only. Results: Two PMX-DHP treatments were performed on 4 patients, three treatments on 6 patients and four treatments on 1 patient. After the therapy, mean arterial pressure increased (69.45 to 84.09 mm Hg; p < 0.01), heart rate decreased (Ill.73 to77.91 beats/min; p < 0.01), white blood cell count decreased (18,380 to 9,550 cells/mm3; p < 0.01), the PMN (polymorphonuclear) percentage decreased (88.45 to 67.82%; p < 0.01) and PaO2/FiO2 increased (275 to 308.09; p < 0.01). All 24 patients survived to the 28-day follow-up. Conclusion: The EA assay can identify patients eligible for PMX-DHP treatment and aids its therapeutic dosing.

© 2010 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Endotoxin Removal in Septic Shock in Clinical Settings

Published online: June 01, 2010
Cover Date: 2010

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0

ISBN: 978-3-8055-9484-4 (Print)
eISBN: 978-3-8055-9485-1 (Online)


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