Hemoadsorption in critical care.

This paper concerns the results of endotoxin hemoadsorption therapy using a PMX column in patients with perforative peritonitis complicated by multiple organ failure. The subjects were 31 patients aged 68 +/- 12 years. When systolic arterial pressure decreased to less than 90 mm Hg, endotoxin hemoadsorption was initiated and continued for 2 h. At the completion of endotoxin hemoadsorption, systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure were significantly increased. Platelet count decreased to less than 50,000/mm(3) in 30% of patients. As for cytokines and vascular endothelial cell function markers, interleukin-6 and plasminogen activator inhibitor-1 significantly decreased. These results suggest favorable effects of endotoxin hemoadsorption on the hemodynamic and pathophysiological conditions in patients with septic shock although attention should be given to the decrease in platelet count.