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VOLUME 18 , ISSUE 12 ( December, 2014 ) > List of Articles

RESEARCH ARTICLE

Alteco endotoxin hemoadsorption in Gram-negative septic shock patients

Hoi-Ping Shum, Yuk Wah Leung,, Sin Man Lam,, King Chung Chan,, Wing Wa Yan

Keywords : Endotoxins, hemoadsorption, septic shock, outcome

Citation Information : Shum H, Leung, YW, Lam, SM, Chan, KC, Yan WW. Alteco endotoxin hemoadsorption in Gram-negative septic shock patients. Indian J Crit Care Med 2014; 18 (12):783-788.

DOI: 10.4103/0972-5229.146305

License: CC BY-ND 3.0

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


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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