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The golden hour of polymyxin B hemoperfusion in endotoxic shock: The basis for sequential extracorporeal therapy in sepsis
Author(s) -
De Rosa Silvia,
Villa Gianluca,
Ronco Claudio
Publication year - 2020
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.13550
Subject(s) - hemoperfusion , extracorporeal , medicine , endotoxic shock , polymyxin b , sepsis , septic shock , shock (circulatory) , polymyxin , antibiotics , resuscitation , pharmacology , immunology , anesthesia , biology , microbiology and biotechnology , hemodialysis
Endotoxin is recognized as a major trigger of the immune response leading to pro‐ and anti‐inflammatory cytokine release, activation of the coagulation cascade, vasoplegic shock, and multiple organ dysfunction syndrome. A beneficial effect could be achieved through extracorporeal adsorption of circulating endotoxins in the blood as adjunctive treatment for unresponsive endotoxic shock. However, the precise clinical indication for its initiation is widely debated in the literature. Similar to the source control, microbiological cultures and antibiotics administration, endotoxin activity assay evaluation at regular intervals, and the targeted use of PMX‐B hemoperfusion could be lifesaving and adequate within the golden hour for the diagnosis and treatment of endotoxic shock.