Case stories & studies

Lipopolysaccharide adsorption in combined therapy of patients with severe sepsis

Our experience of LPS adsorption with the Alteco LPS Adsorber shows evidence of potential efficacy of this method in combined therapy for severe gram-negative sepsis. Further investigations are required.

A New Endotoxin Adsorber in Septic Shock: Observational Case Series

Two-hour hemoperfusion with Alteco LPS Adsorber was initiated in patients with septic shock and endotoxemia. Controls were matched for age, focus and severity of illness. Alteco LPS Adsorber treatment was associated with a decrease in noradrenaline dose, decrease in SOFA scores and LPS concentrations.

A lipopolysaccharide adsorber in adult cardiopulmonary bypass: a single center randomized controlled pilot trial

This study demonstrated the Alteco LPS Adsorber to be safe in a complex cardiac surgery setting.

Clinical experience with a novel endotoxin adsorption device in patients undergoing cardiac surgery

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.

Clinical effects of adsorption of lipopolysaccharide in the treatment of Gram-negative severe sepsis

A statistically significant improvement in hemodynamics, oxygenation, and reduced markers of endotoxemia in group therapy with Alteco LPS Adsorber compared with traditional therapy. These effects were attributed with the removal of endotoxin from the systemic circulation. Only in one case using hemofiltration for acute renal failure in the study group (in the reference group in all patients), 28-day mortality was 16.7% and 66.7% respectively. Negative effects were negligible.

Use of an endotoxin adsorber in the treatment of severe abdominal sepsis

After LPS adsorption with Alteco LPS Adsorber, the level of LPS in the patient's bloodstream was almost eliminated: from 1.44 EU/ml before treatment to 0.03 EU/ml post treatment. The procalcitonin level and inflammatory cytokines were concurrently reduced. Also, an obvious improvement in the status of the patient's hemodynamics was seen. Forty-five days after treatment the patient is still alive. LPS adsorption may represent a significant improvement in the treatment of gram-negative sepsis and further studies are planned.

Preliminary Report regarding the Use of Selective Sorbents in Complex Cardiac Surgery Patients with Extensive Sepsis and Prolonged Intensive Care Stay

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.

Endotoxin Removal in Septic Shock with the Alteco^® LPS Adsorber was Safe But Showed No Benefit Compared to Placebo in the Double-Blind Randomized Controlled Trial - the Asset Study

The termination was made due to difficulties in recruiting subjects, despite modifying the inclusion criteria. The intended number of subjects was 32-44, but the included number of subjects according to protocol was only 8. Because of the low number of subjects recruited according to protocol, any observed differences between the Alteco LPS Adsorber and placebo device groups may be due to random variation. It is therefore not possible to draw any conclusions with respect to performance based on the data collected in this clinical investigation. Adverse event data, safety laboratory, vital sign and Richmond Agitation-Sedation Scale data provide no evidence of any risks associated with Alteco LPS Adsorber treatment.