{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T02:52:05Z","timestamp":1780368725791,"version":"3.54.1"},"reference-count":19,"publisher":"George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures","issue":"2","license":[{"start":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T00:00:00Z","timestamp":1493078400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Sepsis and septic shock are major healthcare problems, resulting in high morbidity and mortality. The Surviving Sepsis Campaign (SSC), which standardised the approach to sepsis, was recently updated. Strategies to decrease the systemic inflammatory response have been proposed to modulate organ dysfunctions. Endotoxin, derived from the membrane of Gram-negative bacteria, is considered a major factor in the pathogenesis of sepsis. Endotoxin adsorption, if effective, has the potential to reduce the biological cascade of Gram-negative sepsis.<\/jats:p>\n                  <jats:p>\n                    We present a case of a 64-year-old man with severe Gram-negative sepsis, following purulent peritonitis secondary to rectosigmoid adenocarcinoma. To reduce the amplitude of the general effects of endotoxins we used a novel device, the Alteco\n                    <jats:sup>\u00ae<\/jats:sup>\n                    LPS Adsorber (Alteco Medical AB, Lund, Sweden), for lipopolysaccharide (LPS) adsorption.\n                  <\/jats:p>\n                  <jats:p>The efficacy markers were: the overall haemodynamic profile, translated into decreased vasopressor requirements, the normalisation of the cardiac index, the systemic vascular resistance index combined with the lactate level and the reduction in procalcitonin (PCT) levels. A decrease in the sequential organ failure assessment (SOFA) score at twenty-four hours was demonstrated.<\/jats:p>\n                  <jats:p>The clinical course following treatment was favourable for the days immediately following the treatment.This was attributed to the removal of endotoxin from the systemic circulation. The patient died one week after the endotoxin removal session, developing an ischemic bowel perforation with subsequent multiple organ failures.<\/jats:p>","DOI":"10.1515\/jccm-2017-0010","type":"journal-article","created":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T06:02:06Z","timestamp":1495173726000},"page":"73-78","source":"Crossref","is-referenced-by-count":1,"title":["Case Report. The Use of Endotoxin Adsorption in Extracorporeal Blood Purification Techniques. A Case Report"],"prefix":"10.62838","volume":"3","author":[{"given":"Adina N.","family":"Hadade","sequence":"first","affiliation":[{"name":"University of Medicine and Pharmacy \u201c Iuliu Hatieganu\u201d, Cluj-Napoca, 1st Department of Anesthesia and Intensive Care , Cluj-Napoca , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caius M.","family":"Breazu","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy \u201c Iuliu Hatieganu\u201d, Cluj-Napoca, 1st Department of Anesthesia and Intensive Care , Cluj-Napoca , Romania"},{"name":"Regional Institute of Gastroenterology and Hepathology \u201c Octavian Fodor\u201d , Cluj-Napoca , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulian V.","family":"Ilie","sequence":"additional","affiliation":[{"name":"University of Veterinary Medicine , Cluj-Napoca , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calin I.","family":"Mitre","sequence":"additional","affiliation":[{"name":"University of Medicine and Pharmacy \u201c Iuliu Hatieganu\u201d, Cluj-Napoca, 1st Department of Anesthesia and Intensive Care , Cluj-Napoca , Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"49540","published-online":{"date-parts":[[2017,5,11]]},"reference":[{"key":"2021040805111466536_j_jccm-2017-0010_ref_001_w2aab2b8c11b1b7b1ab1ab1Aa","doi-asserted-by":"crossref","unstructured":"1. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801-810.","DOI":"10.1001\/jama.2016.0287"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_002_w2aab2b8c11b1b7b1ab1ab2Aa","doi-asserted-by":"crossref","unstructured":"2. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: For the third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):762-774.","DOI":"10.1001\/jama.2016.0288"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_003_w2aab2b8c11b1b7b1ab1ab3Aa","doi-asserted-by":"crossref","unstructured":"3. Rhodes A, Evans LE, Alhazzani W, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017;43(3):304-377.","DOI":"10.1007\/s00134-017-4683-6"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_004_w2aab2b8c11b1b7b1ab1ab4Aa","doi-asserted-by":"crossref","unstructured":"4. Shum HP, Leung YW, Lam SM, Chan KC, Yan WW. Alteco endotoxin hem adsorption in gram-negative septic shock patients. Indian J Crit Care Med. 2014;18(12):783-788.","DOI":"10.4103\/0972-5229.146305"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_005_w2aab2b8c11b1b7b1ab1ab5Aa","doi-asserted-by":"crossref","unstructured":"5. Esteban E, Ferrer R, Alsina L, Artigas A. Immunomodulation in sepsis: The role of endotoxin removal by polymyxin B-immobilized cartridge. Mediators Inflamm. 2013;2013:507539.","DOI":"10.1155\/2013\/507539"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_006_w2aab2b8c11b1b7b1ab1ab6Aa","doi-asserted-by":"crossref","unstructured":"6. Buttenschoen K, Radermacher P, Bracht H. Endotoxin elimination in sepsis: Physiology and therapeutic application. Langenbeck\u2019s Archives of Surgery. 2010;395(6):597-605.","DOI":"10.1007\/s00423-010-0658-6"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_007_w2aab2b8c11b1b7b1ab1ab7Aa","unstructured":"7. Arias-Verdu D, Herrera Gutierrez M, Seller-Perez G, Benitez- Moreno P, Aguiar-Flores E, Quesada-Garcia G. Comparison of two different adsorptive therapies for the treatment of endotoxemia. . 2012;38:S286-S286."},{"key":"2021040805111466536_j_jccm-2017-0010_ref_008_w2aab2b8c11b1b7b1ab1ab8Aa","doi-asserted-by":"crossref","unstructured":"8. Adamik B, Zielinski S, Smiechowicz J, K\u00fcbler A. Endotoxin elimination in patients with septic shock: An observation study. Arch Immunol Ther Exp (Warsz ). 2015;63(6):475-483.","DOI":"10.1007\/s00005-015-0348-8"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_009_w2aab2b8c11b1b7b1ab1ab9Aa","doi-asserted-by":"crossref","unstructured":"9. Andersen TH, Jensen TH, Andersen LW. Adjunctive therapy of severe sepsis and septic shock in adults. 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Yaroustovsky M, Abramyan M, Popok Z, et al. Preliminary report regarding the use of selective sorbents in complex cardiac surgery patients with extensive sepsis and prolonged intensive care stay. Blood Purif. 2009;28(3):227-233.","DOI":"10.1159\/000231988"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_018_w2aab2b8c11b1b7b1ab1ac18Aa","doi-asserted-by":"crossref","unstructured":"18. Harm S, Falkenhagen D, Hartmann J. Endotoxin adsorbents in extracorporeal blood purification: Do they fulfill expectations? Int J Artif Organs. 2014;37(3):222-232.","DOI":"10.5301\/ijao.5000304"},{"key":"2021040805111466536_j_jccm-2017-0010_ref_019_w2aab2b8c11b1b7b1ab1ac19Aa","doi-asserted-by":"crossref","unstructured":"19. Zhou F, Peng Z, Murugan R, Kellum JA. Blood purification and mortality in sepsis: A meta-analysis of randomized trials. 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