A proactive tool in cardiac surgery
The Alteco LPS Adsorber can be a lifesaver and should be used as a pro-active tool to avoid life-threatening situations. By implementing the adsorber in the heart-and lung machine during surgery, organ damage and post-operative complications due to high levels of endotoxin can be avoided, paving the way for a faster recovery.
Avoid the deadly Systemic Inflammatory Response Syndrome (SIRS)
Alteco Medical’s traditional target group is sepsis patients in intensive care units. However, there are other patient groups suffering from endotoxemia (the presence of endotoxin in the blood). One of these are patients undergoing cardiac surgery requiring treatment in heart-lung machine (HLM). These patients are at risk of life-threatening Systemic Inflammatory Response Syndrome (SIRS). SIRS is a medical term for an inflammatory condition throughout the body (system). This reaction is triggered by endotoxin in the bloodstream. When endotoxemia is caused by a bacterial infection, the condition is called sepsis. During major surgical procedures, or in some other severe diseases, translocation of bacteria from the gastrointestinal tract into the bloodstream can arise, which leads to SIRS. This is often the case for Alteco Medical’s new target group. If untreated, this condition can lead to organ failure and a life-threatening situation for the patient.
Implementing the Alteco LPS Adsorber in the heart-lung machine during surgery is a proactive way to prevent post-operative complications caused by high levels of endotoxin, thus paving the way for a safer recovery.
Further reading – cardiac surgery
Thirteen patients with gram-negative sepsis underwent the procedure of selective lipopolysaccharide adsorption using Alteco LPS Adsorber (group I) or Toraymyxin columns (group II). This therapy positively influenced the course of sepsis. After the second procedure, levels of serum endotoxin and procalcitonin markedly decreased in both groups. We also discovered a positive effect on leukocytosis levels and a trend towards normalization of body temperature, improvement of hemodynamic indices and increase of the lung's oxygenating function. Blood cultures taken several days after the procedure were negative.
No adverse events were encountered when the Alteco LPS Adsorber was used in the circuit. Blood flow through the device was easily monitored and kept at the desired level. The Alteco LPS Adsorber can be used safely and is easy to handle in the bypass circuit. No complications related to the use of the device were noted.
"Endotoxemia may indirectly activate the inflammatory cascade. Splanchnic hypoperfusion, a common finding during and following CPB may damage the mucosal barrier, allowing gut translocation of endotoxin. Systemic endotoxin concentrations correlate closely with the degree of cardiovascular dysfunction following CPB."
"CPB may specifically activate the inflammatory response via at least three distinct mechanisms.One mechanism involves direct “contact activation” of the immune system following exposure of blood to the foreign surfaces of the CPB circuit. A second mechanism involves ischemia–reperfusion injury to the brain, heart, lungs, kidney, and liver as a result of aortic cross-clamping. Restoration of perfusion on release of the aortic cross-clamp is associated with activation of key indices of the inflammatory response."
"Endotoxin is a potent trigger of the inflammatory response."
"Cardiac surgery is associated with endotoxemia and a marked acute-phase response. Therefore, endotoxin must be regarded as a pathophysiologic mediator. The role of the gut as a source of endotoxemia following cardiac surgery deserves further attention."