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Related Experiment Videos

A new endotoxin adsorber: first clinical application.

H Ullrich1, W Jakob, D Fröhlich

  • 1Institute for Clinical Chemistry and Laboratory Medicine, University Hospital, Regensburg, Germany.

Therapeutic Apheresis : Official Journal of the International Society for Apheresis and the Japanese Society for Apheresis
|January 10, 2002
PubMed
Summary

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A novel endotoxin adsorption system effectively removed lipopolysaccharide (LPS) in critically ill patients with gram-negative sepsis. This promising immunoadsorption therapy led to significant patient improvement and ICU discharge, with no observed side effects.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Biomedical Engineering

Background:

  • Sepsis, particularly gram-negative sepsis, is a life-threatening condition often associated with high levels of endotoxemia.
  • Lipopolysaccharide (LPS), a component of gram-negative bacterial cell walls, is a key mediator of sepsis-induced inflammation and organ dysfunction.
  • Existing treatments for severe sepsis have limitations, highlighting the need for novel therapeutic approaches.

Purpose of the Study:

  • To evaluate the safety and efficacy of a new whole-blood endotoxin adsorption system in patients with suspected gram-negative sepsis.
  • To assess the system's ability to remove lipopolysaccharide (LPS) from the blood.
  • To observe the clinical outcomes and tolerance of the endotoxin adsorption procedure.

Main Methods:

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  • An open, uncontrolled pilot study involving 6 critically ill patients (5 men, 1 woman) with confirmed endotoxemia and Systemic Inflammatory Response Syndrome (SIRS) criteria.
  • Treatment involved hemoperfusion using a novel whole-blood endotoxin adsorber (Fresenius Endotoxin Adsorber EN 500) with polymethacrylate-bound albumin to remove LPS.
  • Patients had conditions such as pneumonia and peritonitis, and their clinical status was monitored, including Apache II scores.

Main Results:

  • The endotoxin adsorption system demonstrated efficient LPS removal in all treated patients.
  • The procedure was well-tolerated, with no observed side effects during or after treatment.
  • All 6 critically ill patients showed substantial clinical improvement, with their Apache II scores slightly decreasing post-treatment, and were discharged from the intensive care unit.

Conclusions:

  • Whole-blood LPS immunoadsorption using the novel system is a safe and promising method for managing severe gram-negative sepsis.
  • The efficient removal of endotoxins correlated with significant clinical improvement in critically ill patients.
  • Further investigation in large, controlled studies is warranted to confirm the clinical efficacy of this innovative sepsis treatment.