Preliminary report regarding the use of selective sorbents in complex cardiac surgery patients with extensive sepsis and prolonged intensive care stay.
OBJECTIVE
The purpose of this publication is to evaluate the first experiences with the supplemental use of selective endotoxin adsorption cartridges in the treatment of critically ill patients complicated by severe sepsis after cardiac surgery.


METHODS
Thirteen patients with Gram-negative sepsis underwent the procedure of selective lipopolysaccharide (LPS) adsorption using Alteco adsorber (group I) or Toraymyxin columns (polymyxin-B-immobilized fiber) (group II).


RESULTS
This therapy positively influenced the course of sepsis. After the second procedure, levels of serum endotoxin and procalcitonin markedly decreased in both groups. We also discovered a positive effect on leukocytosis levels and a trend towards normalization of body temperature, improvement of hemodynamic indices and increase of the lung's oxygenating function. Blood cultures taken several days after the procedure were negative.


CONCLUSIONS
Our experience with LPS adsorption shows some evidence for the potential efficacy of this method in the treatment of critically ill patients with sepsis. Further investigations are required.
Yaroustovsky
M
M
Bakoulev Scientific Center for Cardiovascular Surgery, Russian Academy of Medical Sciences, Moscow, Russia. mbyar@yandex.ru
Abramyan
M
M
Popok
Z
Z
Nazarova
E
E
Stupchenko
O
O
Popov
D
D
Plushch
M
M
Samsonova
N
N
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D003422:Critical Care / Q000379:methods*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008070:Lipopolysaccharides; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods*; D018805:Sepsis / Q000628:therapy*
D008070:Lipopolysaccharides