Endotoxin and Cytokine Sequential Hemoadsorption in Septic Shock and Multi-Organ Failure

The mortality of septic shock remains high [Ann Intensive Care. 2017;7:19], so apart from usual therapy based on source control and antibiotics, some patients may need rescue therapies. Blood purification systems may play a role by facilitating the nonspecific removal of inflammatory mediators and microbiological toxins. There are different hemoadsorption systems, we describe in this case report the sequential use of Polymyxin B (PMX) endotoxin-adsorbing column (Toraymixin PMX-20R; Toray, Tokyo, Japan) and Cytosorb (R) (Cytosorbents Corp., New Jersey, USA).

Automated summary

The mortality of septic shock remains high and various blood purification systems, such as Polymyxin B endotoxin-adsorbing column and Cytosorb, can be used to remove inflammatory mediators and microbiological toxins in addition to standard therapy based on source control and antibiotics.