Case stories & studies

Case Report. The Use of Endotoxin Adsorption in Extracorporeal Blood Purification Techniques. A Case Report

A case of a 64-year-old man with severe gram-negative sepsis was presented. To reduce the amplitude of the general effects of endotoxin the Alteco LPS Adsorber was used.
The efficacy markers were the overall hemodynamic profile, translated into decreased vasopressor requirements, the normalization of the cardiac index, and the systemic vascular resistance index combined with the lactate level and the reduction in procalcitonin levels. A decrease in the sequential organ failure assessment (SOFA) score at twenty-four hours was demonstrated.
The clinical course following treatment was favorable for the days immediately following the treatment. This was attributed to the removal of endotoxin from the systemic circulation.

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.

Selective adsorption of endotoxin in the complex treatment of patients with severe sepsis

A session with Alteco LPS Adsorber caused a significant drop in the blood level of endotoxin and procalcitonin and it was accompanied by a trend toward better hemodynamics and lung gas exchange and alleviated organ dysfunction.

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.

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.

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.

Endotoxin Elimination in Patients with Septic Shock: An Observational Study

Endotoxin elimination was performed using hemoperfusion with the Alteco LPS Adsorber. Effective endotoxin elimination resulted in a significant improvement in hemodynamic parameters and of organ function. The application of the EA assay was useful for the bedside monitoring of endotoxemia in critically ill ICU patients.