816
document
Blood purification for critical care medicine : endotoxin adsorption . Many kinds of blood purifying technologies have been applied to the treatment of critically ill patients since 1979 when plasma exchange with hollow-fiber membranes was developed . These technologies have been applied not only to the removal of toxic substances , but also to the treatment of objective diseases and the removal of the factors relating to the associated inflammation . This article summarizes these methods and their efficacies for critically ill patients , especially those with severe sepsis . Attempts have been made to remove endotoxin , the main cause of sepsis , from the circulation using polymyxin B immobilized fiber , charcoal hemoperfusion , and plasma or whole blood exchange . Attempts have also been made to remove proinflammatory cytokines , eicosanoides , and coagulative factors from the circulation in the human body . Continuous hemofiltration or hemodiafiltration is the representative technology . The efficacy of these methods has been established , but several issues remain unresolved . All methods of the treatment of severe sepsis are discussed with reference to treatment indications , efficacy , and outcome parameters . In particular , the clinical results of endotoxin removal with polymyxin B immobilized fiber are summarized in this article .
817
Intervention_Physical
Blood purification
818
Intervention_Physical
blood purifying technologies
819
Intervention_Pharmacological
polymyxin B immobilized fiber
820
Intervention_Pharmacological
charcoal hemoperfusion
821
Intervention_Physical
plasma or whole blood exchange
822
Intervention_Pharmacological
polymyxin B immobilized fiber
823
Outcome_Physical
Blood purification
824
Outcome_Other
efficacy
825
Outcome_Other
indications
826
Outcome_Other
efficacy
827
Participant_Condition
critically ill patients , especially those with severe sepsis .