A new endotoxin adsorber in septic shock: observational case series

Abstract

Aims: Effects of a new endotoxin adsorber on the length of noradrenaline (NA) treatment, LPS (lipopolysaccharide) levels and SOFA (sequential organ failure assessment) scores in septic shock were evaluated.

Methods: Two-hour hemoperfusion with LPS adsorber was initiated in patients with septic shock and endotoxemia. Controls were matched for age, focus and severity of illness.

Results: Adsorption treatment (n = 9) exhibited a significant decrease in EAA (endotoxin activity assay) activity (0.55 [0.44-0.68] vs. 0.25 [0.13-0.41], p = 0.019) and NA infusion rate (0.217 μg/kg/min [0.119-0.0508] vs. 0 μg/kg/min [0-0.09], p = 0.026) from pretreatment to 24 h post-treatment. The median decrease in SOFA scores from pretreatment to 24 h was 3.0 points (1.5-4.5), p = 0.002. Duration of NA infusion was significantly shorter compared to controls (39 h [31-48] vs. 54 h [43-151], p = 0.03).

Conclusions: LPS adsorber treatment was associated with a decrease in NA dose, decrease in SOFA scores and LPS concentrations.