Extracorporeal Endotoxin Removal in Sepsis

  • C. Ronco
  • D. Cruz
  • F. Nalesso
  • P. Piccinni
Conference paper


Despite the relevant improvements in knowledge and care, the incidence of death in intensive care units (ICU) due to sepsis is still very high [1]. About 30% of septic patients die as a consequence of the progression of sepsis to septic shock and multiorgan failure [2]. Specific care protocols were introduced into clinical practice to rapidly identify and treat septic patients [Surviving Sepsis Campaign (SSC) guidelines] [3]. In fact, early diagnosis of sepsis could first result in reduced mortality rates, and second, the cost associated with sepsis could be lowered. A better understanding of the biological mechanisms involved in sepsis trigger and progression is fundamental for choosing appropriate treatment. The septic syndrome arises from the activation of innate host response, leading to a variety of clinical symptoms not specifically related to the presence of an infection. Moreover, microbial products, i.e. endotoxin [lipopolysaccharide (LPS)], and host-derived molecules can evoke the immune response. It is thus useful to rapidly recognise an abnormal immune response and specifically identify the presence of organisms and molecules able to trigger that response. The role of a specific diagnostic procedure could be profitably represented by quantifying circulating endotoxin and its interaction with the immune system. As the presence of small amounts of endotoxin can operate as an alarm molecule aiding the immune system to perform its antimicrobial action, the presence of large amounts of endotoxin could trigger an abnormal immune response itself. In the latter case, the endotoxin could represent the therapeutic target during sepsis.


Septic Shock Mean Arterial Pressure Sequential Organ Failure Assessment Continuous Renal Replacement Therapy Sequential Organ Failure Assessment Score 
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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • C. Ronco
  • D. Cruz
  • F. Nalesso
  • P. Piccinni

There are no affiliations available

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