Endotoxin activity level and septic shock: a possible role for specific anti-endotoxin therapy?
Endotoxin activity (EA) plays an essential role in sepsis syndrome pathogenesis. There has been considerable interest in measuring and removing EA to predict and improve the morbidity and mortality of patients with sepsis. We performed a prospective study to assess the prevalence of EA in critically ill patients and its association with organ dysfunction and outcome, as well as in septic shock. EA (EAA(TM)) was measured within 24 h from onset of refractory septic shock in an intensive care unit. Our study demonstrated that EA level is independent from the type or the source of infection, but reflects the severity of illness in critically ill septic shock patients. Extracorporeal EA removal (PMX-HP) was assessed following our ICU clinical practice. PMX-HP seems to have better outcome, but further studies are required to verify this hypothesis.
Monti
Gianpaola
G
Bottiroli
Maurizio
M
Pizzilli
Giacinto
G
Minnini
Maria
M
Terzi
Valeria
V
Vecchi
Irene
I
Gesu
Giovanni
G
Brioschi
Paolo
P
Vesconi
Sergio
S
Casella
Giampaolo
G
D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016638:Critical Illness; D004731:Endotoxins / Q000097:blood* / Q000302:isolation & purification; D004837:Epinephrine / Q000097:blood; D005112:Extracorporeal Circulation / Q000379:methods*; D016905:Gram-Negative Bacterial Infections / Q000097:blood* / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D007773:Lactates / Q000097:blood; D009638:Norepinephrine / Q000097:blood; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000628:therapy; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood* / Q000628:therapy; D014655:Vascular Resistance
D015415:Biomarkers; D004731:Endotoxins; D007773:Lactates; D010100:Oxygen; D009638:Norepinephrine; D004837:Epinephrine