[Early use of polymyxin B in sepsis]

During sepsis, lipopolysaccharide released by gram-negative bacteria induces activation of inflammatory pathways resulting in organ dysfunction and failure. Extracorporeal therapies that remove this molecule and support organ function are useful in critically ill patients in ICUs. Today, blood purification therapies such as high-volume hemofiltration, polymyxin B hemoperfusion, and coupled plasma filtration adsorption are easy to perform. According to the reconciliation of the three sepsis theories and thanks to the removal of lipopolysaccharide (the first inflammatory stimulus) from the blood, we can provide an effective and useful extracoporeal therapy for this clinical condition.