[Endotoxin adsortion as adjuvant therapy in gram negative severe sepsis].
The mortality rate of severe sepsis and septic shock remains still high. Within the last years a better knowledge of its physiopathology and the implementation of a group of measures addressed to a fast identification and early treatment of the septic patients have proved to reduce mortality rate. Likewise, it continues being investigated in modulating the inflammatory response and limiting the harmful action of the bacterial products on the immune system. As a result of this research some endotoxin adsorber devices have been designed to control one of the most important targets that start the inflammatory cascade when gram negative microorganisms are involved.The usefulness that these endotoxin removal devices might have as adjuvant treatment in the Septic Syndrome and its applicability are reviewed in this paper. Likewise a profile of patient that might be to the benefit of this therapy is suggested according to the current knowledge.
Candel
F J
FJ
Servicio de Microbiología Clínica, Hospital Clinico Universitario San Carlos, Madrid, Spain. fj.candel@terra.es
Martínez-Sagasti
F
F
Borges
M
M
Maseda
E
E
Herrera-Gutiérrez
M
M
Garnacho-Montero
J
J
Maynar
F J
FJ
Zaragoza
R
R
Mensa
J
J
Azanza
J R
JR
D000327:Adsorption; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003422:Critical Care; D004731:Endotoxins / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000628:therapy*; D006464:Hemoperfusion; D006801:Humans; D011113:Polymyxins / Q000627:therapeutic use; D018805:Sepsis / Q000188:drug therapy / Q000628:therapy*; D013030:Spain
D000900:Anti-Bacterial Agents; D004731:Endotoxins; D011113:Polymyxins