Sepsis is a major health problem and remains an important cause of death worldwide. The failure to convert advances in our understanding of the biologic features of sepsis into effective new therapies questions the current approach to the development of sepsis drugs, and suggests a need for newer and better clinical trial design. Blood purification for sepsis is a promising therapeutic strategy to improve survival and reduce organ failure in patients with severe sepsis and septic shock.

Keywords:
Sepsis, Polymyxin B hemoperfusion, Surviving Sepsis Campaign
1.
Bone RC, Sibbald WJ, Sprung CL: The ACCP-SCCM consensus conference on sepsis and organ failure. Chest 1992;101:1481-1483.
2.
Levy MM, Fink MP, Marshall JC, et al: 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31:1250-1256.
3.
Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Garcillo J, Pinsky MR: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated cost of care. Crit Care Med 2001;7:1303-1310.
4.
Kissoon N, Carcillo JA, Espinosa V, et al: World federation of pediatric intensive care and critical care societies: global sepsis initiative. Pediatric Crit Care Med 2011:5:494-503.
5.
Dellinger RP, Levy MM, Rhodes A, et al: Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013;39;165-228.
6.
Kumar G, Kumar N, Taneja A, et al: Nationwide trends of severe sepsis in the 21st century (2000-2007). Chest 2011;140:1223-1231.
7.
Ferrer R, Artigas A, Levy MM, et al: Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain. JAMA 2008;299:2294-2303.
8.
Levy MM, Dellinger RP, Wowsend SR, et al: The surviving sepsis campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med 2010;38:367-374.
9.
Dombrovskiy VY, Martin AA, Sunderram J, Paz HL: Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003. Crit Care Med 2007;35:1244-1250.
10.
Esteban A, Frutos-Vivar F, Ferguson ND, et al: Sepsis incidence and outcome: contrasting the intensive care unit with the hospital ward. Crit Care Med 2007;35:1284-1289.
11.
Martin GS, Mannino DM, Eaton S, Moss M: The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;348:1546-1554.
12.
Angus DC, Carlt J: Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensvie Care Med 2003;29:368-377.
13.
Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP: The natural history of the systemic inflammtory response syndrome (SIRS): a prospective study. JAMA 1995;273:117-123.
14.
Angus DC, van der Poll T: Critical care medicine: severe sepsis and septic shock. N Engl J Med 2013;369:840-851.
15.
Akira S, Uematsu S, Takeuchi O: Pathogen recognition and innate immunity. Cell 2006;124:784-801.
16.
Zhang Q, Raoff M, Chen Y, et al: Circulating mitochondrial DAMPs cause inflammatory responses to injury. Nature 2010;464:104-107.
17.
Opal SM: The host response to endotoxin, antipilopolysac charide strategies and the management of severe sepsis. Int J Med Microbiol 2007;297:365-377.
18.
Da Silva AMT, Kaulbach HC, Chuidian FS, Lambert DR, Suffredini AF, Danner RL: Brief report: shock and multiple-organ dysfunction after self-administration of salmonella endotoxin. N Engl J Med 1993;328:1457-1461.
19.
McCloskey RV, Straube RC, Sanders C, Smith SM, Smith CR: Treatment of septic shock with human monoclonal antibody HA-1A: a randomized, double blind, placebo-controlled trial. Ann Int Med 1994;121:1-5.
20.
Angus DC, Birmingham MC, Balk RA, et al: E5 murine monoclonal antiendotoxin antibody in Gram-negative sespis: a randomized controlled trial. JAMA 2000;283:1723-1730.
21.
Dellinger PR, Tomayko JF, Angus DC, et al: Efficacy and safety of a phospholipidemulsion (GR270773) in Gram-negative severe sepsis: results of a phase II multicenter, randomized, placebo-controlled, dose-finding clinical trial. Crit Care Med 2009;37:2929-2938.
22.
Tidswell M, Tillis W, Larosa SP, et al: Phase 2 trial of eritoran tetrasodium (E5564), a Toll-like receptor 4 antagonist, in patients with severe sepsis 2010;38;72-83.
23.
Kellum JA, Kong L, Fink MP, et al: Understanding the inflammatory cytokine response in pneumonia and sepsis: results of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Study. Arch Intern Med 2007;167:1655-1663.
24.
Zhou F, Peng Z, Murugan R, Kellum JA: Blood purification and mortality in sepsis: a meta-analysis of randomized trials. Crit Care Med 2013;41:2209-2220.
25.
Gogos CA, Drosou E, Basaris HP, et al: Pro- versus anti-inflammatory cytokine profile in patients with severe sepsis: a marker for prognosis and future therapeutic options. J Infect Dis 2000;181:176-180.
26.
Taniguchi T, Sato K, Kurita A, Noda T, Okajima M: Efficacy of endotoxin adsorption therapy (polymyxin B hemoperfusion) for methicillin-resistant Staphylococus aureus toxic shock syndrome: a case report about five patients. Minerva Anestesiol 2013;79:758-761.
27.
Nakamura T, Ushiyama C, Suzuki Y, et al: Combination therapy with polymyxin B-immobilized fibre haemoperfusion and teicoplanin for sepsis due to methicillin-resistant Staphylococcus aureus. J Hosp Infect 2003;53:58-63.
© 2014 S. Karger AG, Basel
2014
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