{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T10:18:46Z","timestamp":1769854726544,"version":"3.49.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We sought to evaluate the clinical implication of endotoxin levels in gram-negative bacilli (GNB)-induced abdominal septic shock patients with polymyxin B-hemoperfusion (PMX-HP) treatment. A prospective cohort of 60 patients who received surgical infectious source control for abdominal sepsis from January 2019 to December 2020 was included in the study. Endotoxin activity (EA) levels and Sequential Organ Failure Assessment (SOFA) scores were assessed immediately after surgery (baseline), 24, and 48\u00a0h post baseline. With receiver operating characteristic curves, the patients were stratified into two groups by the EA cut-off value (high-risk group vs low-risk group) and the clinical outcomes were compared. Logistic regression was performed to identify the clinical impact of PMX-HP on in-hospital death. Among the 31 high-risk patients (EA level \u2265\u20090.54), 16 patients (51.6%) received PMX-HP treatment and showed significant decreases in EA levels compared to patients who underwent conventional treatment only (\u2212\u20090.34 vs \u2212\u20090.12, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). SOFA scores also showed significant improvement with PMX-HP treatment (12.8\u20138.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Fourteen in-hospital deaths occurred (45.2%), and PMX-HP treatment had a protective effect on in-hospital death (odds ratio (OR) 0.04, <jats:italic>p<\/jats:italic>\u2009=\u20090.03). In 29 low-risk patients (EA level &lt;\u20090.54), seven patients (24.1%) received PMX-HP treatment and showed significant decreases in EA levels (0.46\u20130.16, <jats:italic>p<\/jats:italic>\u2009=\u20090.018). However, SOFA scores and in-hospital deaths were not improved by PMX-HP treatment. EA level significantly decreased after PMX-HP treatment and it may represent a therapeutic option to improve organ impairment and in-hospital death in septic shock patients with EA levels exceeding 0.54.<\/jats:p>","DOI":"10.1038\/s41598-021-03055-8","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T11:07:13Z","timestamp":1639652833000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Impact of polymyxin B hemoperfusion therapy on high endotoxin activity level patients after successful infection source control: a prospective cohort study"],"prefix":"10.1038","volume":"11","author":[{"given":"Won Young","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee Ju","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Young","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"3055_CR1","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.jcrc.2013.02.005","volume":"28","author":"E Biagioni","year":"2013","unstructured":"Biagioni, E. et al. Endotoxin activity levels as a prediction tool for risk of deterioration in patients with sepsis not admitted to the intensive care unit: A pilot observational study. J. Crit. Care 28, 612\u2013617. https:\/\/doi.org\/10.1016\/j.jcrc.2013.02.005 (2013).","journal-title":"J. Crit. Care"},{"key":"3055_CR2","doi-asserted-by":"publisher","first-page":"R102","DOI":"10.1186\/cc7934","volume":"13","author":"F Valenza","year":"2009","unstructured":"Valenza, F. et al. Prevalence of endotoxemia after surgery and its association with ICU length of stay. Crit. Care 13, R102. https:\/\/doi.org\/10.1186\/cc7934 (2009).","journal-title":"Crit. Care"},{"key":"3055_CR3","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1007\/s00134-018-5463-7","volume":"44","author":"DJ Klein","year":"2018","unstructured":"Klein, D. J. et al. Polymyxin B hemoperfusion in endotoxemic septic shock patients without extreme endotoxemia: A post hoc analysis of the EUPHRATES trial. 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