Therapeutic apheresis for septic patients with organ dysfunction: Hemoperfusion using a polymyxin B immobilized column

A prospective clinical study was performed to evaluate a new method of trea tment of endotoxin shock, a column containing polystyrene fibers with coval ently bound immobile polymyxin B. Direct hemoperfusion using the column rem oves circulating endotoxin by adsorption. All of the patients studied, 37 i n the treatment group and 33 in the control group, had endotoxemia and fail ure of I or more organs. The perfusion was performed 1-7 times per patient, 2 h/session. The survival rate was significantly higher in the treatment g roup (54%) than in the controls (36.4%). The mean plasma endotoxin concentr ation was significantly lowered by the treatment from 83.7 pg/ml before per fusion to 56.4 pg/ml immediately after and 28.5 pg/ml the day after the tre atment, and the posttreatment lever was much lower in those who survived (m ean, 18.8 pg/ml) compared to those who died (mean, 88 pg/ml). Various param eters of cardiac function also improved after the treatment.