title: A pilot study of selective lipopolysaccharide adsorption and coupled plasma filtration and adsorption in adult patients with severe sepsis.
abstract: OBJECTIVE
  To evaluate the safety and effectiveness of combined extracorporeal therapy in patients with severe sepsis after cardiac surgery.
  
  
  METHODS
  Twenty patients received combined extracorporeal therapy (LPS-adsorption with Toraymyxin columns + CPFA). The inclusion criteria were clinical signs of severe sepsis, EAA = 0.6, and PCT >2 ng/ml. 20 comparable patients in the control group received only standard therapy.
  
  
  RESULTS
  Each patient in the study group received 2 daily treatments of combined extracorporeal therapy. In contrast to controls, we noted an increase in the values of MAP from 73 to 82 mm Hg, (p < 0.001) and the mean oxygenation index (from 180 to 246, p < 0.001), decrease of EAA from 0.77 to 0.55, p < 0.001, and PCT (from 6.23 to 2.83 ng/ml, p < 0.001). The 28-day survival rate was 65 and 35% in the study and control groups respectively, p = 0.11.
  
  
  CONCLUSIONS
  The combined use of LPS-adsorption and CPFA in a single circuit with standard therapy is a safe and possibly effective adjunctive method for treating severe sepsis.
authors.forename: Michail
authors.initials: M
authors.lastname: Yaroustovsky
authors.forename: Marina
authors.initials: M
authors.lastname: Abramyan
authors.forename: Nickolay
authors.initials: N
authors.lastname: Krotenko
authors.forename: Dmitry
authors.initials: D
authors.lastname: Popov
authors.forename: Marina
authors.initials: M
authors.lastname: Plyushch
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Rogalskaya
mesh_terms: D000327:Adsorption; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008070:Lipopolysaccharides / Q000097:blood / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011112:Polymyxin B / Q000737:chemistry*; D011485:Protein Binding; D018805:Sepsis / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D008070:Lipopolysaccharides; D011112:Polymyxin B