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      Alteco endotoxin hemoadsorption in Gram-negative septic shock patients

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          Abstract

          Background and Aims:

          Severe sepsis and septic shock are common causes of mortality and morbidity in an intensive care unit setting. Endotoxin, derived from the outer membranes of Gram-negative bacteria, is considered a major factor in the pathogenesis of sepsis. This study investigated the effect of Alteco endotoxin hemoadsorption device on Gram-negative septic shock patients.

          Materials and Methods:

          An open, controlled, prospective, randomized, single-center trial was conducted between February 2010 and June 2012. Patients with septic shock due to intra-abdominal sepsis were randomized to either conventional therapy ( n = 8) or conventional therapy plus two 2-hourly sessions of Alteco endotoxin hemoadsorption ( n = 7). Primary endpoint was the Sequential Organ Failure Assessment (SOFA) score changes from 0 to 72 h. Secondary end points included vasopressor requirement, PaO 2/FiO 2 ratio (PFR), length of stay (LOS), and 28-day mortality.

          Results:

          This study was terminated early as interim analysis showed a low probability of significant findings. No significant difference was noted between the two groups with respect to change in SOFA score, vasopressor score, PFR, LOS, and 28-day mortality. Side-effect was minimal.

          Conclusions:

          We could not identify any clinical benefit on the addition of Alteco endotoxin hemoadsorption to conventional therapy in patients who suffered from intra-abdominal sepsis with shock. The side effect profile of this novel device was acceptable.

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          Author and article information

          Journal
          Indian J Crit Care Med
          Indian J Crit Care Med
          IJCCM
          Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
          Medknow Publications & Media Pvt Ltd (India )
          0972-5229
          1998-359X
          December 2014
          : 18
          : 12
          : 783-788
          Affiliations
          From: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China
          Author notes
          Correspondence: Dr. Hoi Ping Shum, Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR, China. E-mail: shumhp@ 123456ha.org.hk
          Article
          IJCCM-18-783
          10.4103/0972-5229.146305
          4271277
          Copyright: © Indian Journal of Critical Care Medicine

          This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

          Categories
          Research Article

          Emergency medicine & Trauma

          endotoxins, hemoadsorption, septic shock, outcome

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