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. 2020 Feb;44(2):184-186.
doi: 10.1111/aor.13550. Epub 2019 Sep 2.

The golden hour of polymyxin B hemoperfusion in endotoxic shock: The basis for sequential extracorporeal therapy in sepsis

Silvia De Rosa  1   2 , Gianluca Villa  1   3 , Claudio Ronco  1   4   5
Affiliations

The golden hour of polymyxin B hemoperfusion in endotoxic shock: The basis for sequential extracorporeal therapy in sepsis

Silvia De Rosa et al. Artif Organs. 2020 Feb.

Abstract

Endotoxin is recognized as a major trigger of the immune response leading to pro- and anti-inflammatory cytokine release, activation of the coagulation cascade, vasoplegic shock, and multiple organ dysfunction syndrome. A beneficial effect could be achieved through extracorporeal adsorption of circulating endotoxins in the blood as adjunctive treatment for unresponsive endotoxic shock. However, the precise clinical indication for its initiation is widely debated in the literature. Similar to the source control, microbiological cultures and antibiotics administration, endotoxin activity assay evaluation at regular intervals, and the targeted use of PMX-B hemoperfusion could be lifesaving and adequate within the golden hour for the diagnosis and treatment of endotoxic shock.

Keywords: endotoxic shock; hemoperfusion; sequential extracorporeal therapy.

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Conflict of interest statement

The authors have no conflicts of interest to declare related to this manuscript.

Figures

Figure 1
Figure 1
Flowchart for endotoxin shock management and therapeutic targets
See this image and copyright information in PMC

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