Use of an endotoxin adsorber in the treatment of severe abdominal sepsis.
Methods for lipopolysaccharide (LPS) (endotoxin) reduction have been proposed as one way to improve the treatment of Gram-negative sepsis. Here we present a case with severe Gram-negative sepsis, treated with a novel device for LPS adsorption (Alteco LPS Adsorber, Alteco Medical AB, Lund, Sweden). After LPS adsorption, the level of LPS in the patient's bloodstream was almost eliminated: from 1.44 EU/ml before treatment to 0.03 EU/ml post treatment). The procalcitonin level and inflammatory cytokines were concurrently reduced. Also, an obvious improvement in the status of the patient's hemodynamics was seen. Forty-five days after treatment the patient is still alive. In conclusion, LPS adsorption may represent a significant improvement in the treatment of Gram-negative sepsis and further studies are planned.
Kulabukhov
V V
VV
Department of Anesthesiology and Resuscitation, Purulent-Septic Surgery Clinic of National Medical Surgery Center N. Pirogov, Moscow, Russia. Vkulabukhov@gmail.com
D000005:Abdomen / Q000382:microbiology*; D000208:Acute Disease; D000327:Adsorption; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D002763:Cholecystectomy; D006464:Hemoperfusion / Q000379:methods*; D006470:Hemorrhage / Q000150:complications; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008070:Lipopolysaccharides / Q000097:blood*; D008297:Male; D009102:Multiple Organ Failure / Q000382:microbiology / Q000628:therapy; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications; D011498:Protein Precursors / Q000097:blood; D011550:Pseudomonas aeruginosa; D051437:Renal Insufficiency / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology; D018805:Sepsis / Q000382:microbiology / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000925:Anticoagulants; C000606589:CALCA protein, human; D008070:Lipopolysaccharides; D011498:Protein Precursors; D006493:Heparin; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide