Sepsis is the body’s overwhelming and life-threatening response to infection that can lead to tissue damage, organ failure, and death. By removing endotoxin from the bloodstream during extracorporeal treatment, Alteco LPS Adsorber can turn the course of sepsis and stabilize the patient’s hemodynamic parameters in 2 hours. 1
Did you know that sepsis causes 1 in 5 deaths globally?
What causes sepsis?
Sepsis can be caused by a specific toxin (endotoxin) entering the blood stream. Endotoxin, or lipopolysaccharide (LPS), is a major component of the cell wall of gram-negative bacteria. When endotoxin is released into the bloodstream, a strong reactive response is produced by the immune system which can develop into sepsis. 2
Sepsis can be a life-threatening symptom of gram-negative bacterial infection.
How common is sepsis?
Sepsis is one of the most common causes of death in modern intensive care. With nearly 49 million cases worldwide and 11 million deaths globally per year – or 1 in 5 – it is now thought that sepsis kills more people than cancer. 3
What are the consequences of sepsis?
Up to 50% of sepsis survivors go through post-sepsis syndrome. This means a higher risk of rehospitalization, infection, stroke, heart attack, and effects such as impaired cognitive and/or physical functions and post-traumatic stress disorder (PTSD). 4 It is estimated that up to 8% of sepsis patients need one or more surgical amputations. 5
Who is at risk?
Sepsis can happen to anyone, but individuals who are more susceptible to contract an infection are also at higher risk of sepsis: infants, the elderly and people who have an impaired immune system. 6 The most common risk factor for sepsis is hospitalization: the longer the admission time, the higher the risk of a nosocomial infection. 7
What is sepsis? Sepsis explained in 3 minutes – video by Global Sepsis Alliance
Take endotoxin out of the picture!
Take endotoxin out of the picture with the Alteco LPS Adsorber
Endotoxin (LPS) is one of the strongest bacterial inducers of inflammatory cytokines. 8 Use Alteco LPS Adsorber early to inhibit the complement cascade and avoid cytokine storms and organ failure. Early start of treatment with Alteco LPS Adsorber aims to stabilize patient’s hemodynamic parameters and reverse the sepsis process before septic shock occurs. Turning the course of sepsis with Alteco LPS Adsorber may potentially avoid further damage to the kidneys and acute CRRT treatment and may allow more time to find and treat the source of infection that caused the sepsis.
Gram-positive or gram-negative sepsis?
Gram-negative and gram-positive sepsis are equally likely to be the causative pathogens of sepsis. 9 Endotoxin is frequently found in the systemic circulation during sepsis, regardless of the actual microorganism found in the blood culture. 10 In most cases, it is not known – at least not early enough in the treatment process – whether the patient has a gram-positive or gram-negative bacterial infection, simply because lab results may take too long. Irrespectively, considering that mortality from sepsis increases with nearly 8% for every hour that treatment is delayed, early treatment start is critical. 11
Endotoxin and gram-positive sepsis
Endotoxin is significant also in gram-positive sepsis, as the gram-positive bacteria cause hypersensitivity to endotoxin. Therefore, it may be beneficial to remove endotoxin also in cases where the infection is caused by gram-positive bacteria. 12 Studies have also indicated positive treatment results when the Alteco LPS Adsorber was used on gram-positive sepsis. 13
More about endotoxin and sepsis
…”gram-negative bacteria produce lipopolysaccharides as endotoxins, which activate toll-like receptors on macrophages and other cells, eliciting the release of pro-inflammatory cytokines and chemokines. Constant stimulation of toll-like receptors leads to damage of vascular endothelial cells and causes blood-clotting abnormalities, eventually resulting in tissue injury, multiple organ dysfunction, and death.”
This case report describes how endotoxin adsorption and cytokine removal can be complementary. "Rapid control of the inflammatory response, modulating not only the inducing stimulus but also the inflammatory mediators, can achieve an early improvement."
Prolonged Cardiopulmonary Bypass is a Risk Factor for Intestinal Ischaemic Damage and Endotoxaemia
2 Pathophysiology of endotoxic shock, ICU Management & Practice, Volume 18 – Issue 3, 2018
3 The Lancet, Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study
4 Life After Sepsis fact sheet, Sepsis Alliance
5 AMPUTATION OF LOWER LIMB CAUSED BY SEPSIS?
6 Sepsis Alliance, Risk Factors
7 Winchester Hospital, Health Library
8 Exotoxins and endotoxins: Inducers of inflammatory cytokines
9 Are gram-positive or gram-negative bacteria more likely to cause sepsis/septic shock?
10 Diagnostic and Prognostic Implications of Endotoxemia in Critical llness: Results of the MEDIC Study
11 Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock
12 The immunopathogenesis of sepsis
13 Endotoxin Elimination in Patients with Septic Shock: An Observation Study