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https://www.readbyqxmd.com/read/25765778/a-pilot-study-of-selective-lipopolysaccharide-adsorption-and-coupled-plasma-filtration-and-adsorption-in-adult-patients-with-severe-sepsis
#1
Michail Yaroustovsky, Marina Abramyan, Nickolay Krotenko, Dmitry Popov, Marina Plyushch, Ekaterina Rogalskaya
AIM: To evaluate the safety and effectiveness of combined extracorporeal therapy in patients with severe sepsis after cardiac surgery. MATERIALS AND METHODS: Twenty patients received combined extracorporeal therapy (LPS-adsorption with Toraymyxin columns + CPFA). The inclusion criteria were clinical signs of severe sepsis, EAA = 0.6, and PCT >2 ng/ml. 20 comparable patients in the control group received only standard therapy. RESULTS: Each patient in the study group received 2 daily treatments of combined extracorporeal therapy...
2015: Blood Purification
https://www.readbyqxmd.com/read/25306683/-experience-of-using-endotoxin-selective-adsorption-in-patients-with-severe-sepsis-after-open-heart-surgery
#2
M B Iarustovskiĭ, M V Abramian, N P Krotenko, D A Popov, M G Pliushch, E I Nazarova, S L Gordeev
PURPOSE OF THE STUDY: To evaluate the safety and effectiveness of selective lipopolysaccharide (LPS)-adsorption therapy using polymyxin B immobilised fibre cartridges in adult patients complicated with severe sepsis after cardiac surgery. METHODS: 105 patients received extracorporeal LPS-adsorption procedures using Toraymyxin columns--PMX (Toray, Japan) in addition to the standard treatment according to the Surviving Sepsis Campaign guideline study group. For control group we selected 40 patients, comparable by PMX group in age, body weight, severity of illness, and the duration of cardiopulmonary bypass, received only standard therapy...
May 2014: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/24811184/endotoxin-adsorption-using-polymyxin-b-immobilized-fiber-cartridges-in-severe-sepsis-patients-following-cardiac-surgery
#3
Michail Yaroustovsky, Marina Abramyan, Nickolay Krotenko, Dmitry Popov, Marina Plyushch, Zakhar Popok
INTRODUCTION: Sepsis still represents an obstacle in modern medicine. The purpose of this study was to evaluate the safety and effectiveness of selective lipopolysaccharide (LPS)-adsorption therapy using polymyxin B immobilized fiber cartridges in adult patients complicated with severe sepsis after cardiac surgery. METHODS: 65 patients received extracorporeal LPS-adsorption procedures using Toraymyxin columns (PMX; Toray, Tokyo, Japan) in addition to the standard treatment according to the Surviving Sepsis Campaign guidelines...
April 2014: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/24744167/endotoxin-adsorbents-in-extracorporeal-blood-purification-do-they-fulfill-expectations
#4
Stephan Harm, Dieter Falkenhagen, Jens Hartmann
INTRODUCTION: Lipopolysaccharides (LPS) are extremely strong stimulators of inflammatory reactions, act at very low concentrations, and are involved in the pathogenesis of sepsis and septic shock. Because of its toxicity, the efficient removal of endotoxin from patients' blood is very important in clinical medicine. The purpose of this study was to determine the endotoxin adsorption capacities of commercial endotoxin adsorbers for endotoxin removal in buffer solution, protein solution, serum and heparinized plasma; some of these were also characterized in whole blood...
March 2014: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/24457492/polymyxin-b-hemoperfusion-in-clinical-practice-the-picture-from-an-unbound-collaborative-registry
#5
(no author information available yet)
After the publication of the EUPHAS trial, the clinical use of polymyxin B hemoperfusion (Toraymyxin®) increased significantly in Italy. Nevertheless, no structured data collections have been carried out to underline the characteristics of treated patients. Therefore, a collaborative registry of clinical data was promoted among users in order to better define the structure of the prospective data collection named the EUPHAS2 project. Neither inclusion criteria nor therapeutic constraints were imposed, highlighting adherence to clinical evidence provided by previous randomized controlled trials, and also unusual or borderline practice in the selection of patients for polymyxin B-based cartridges (PMX-DHP)...
2014: Blood Purification
https://www.readbyqxmd.com/read/23817653/direct-hemoperfusion-with-polymyxin-b-immobilized-cartridge-in-severe-sepsis-due-to-intestinal-perforation-hemodynamic-findings-and-clinical-considerations-in-anticoagulation-therapy
#6
MULTICENTER STUDY
Javier Maynar, Fernando Martínez-Sagasti, Manuel Herrera-Gutiérrez, Francisco Martí, Francisco Javier Candel, Javier Belda, Sergio Castaño, José Ángel Sanchez-Izquierdo
BACKGROUND: High levels of endotoxin have been reported as a risk factor for mortality in critical patients. Toraymyxin® is a column designed to remove circulating blood endotoxin by direct hemoperfusion widely used in Japan. OBJECTIVES: To evaluate the effect of direct hemoperfusion with Toraymyxin® (DHP-PMX) as an adjuvant treatment in patients with severe sepsis due to intestinal perforation in terms of hemodynamic function and coagulation abnormalities. METHODS: Prospective cohort study with a historical control group...
June 2013: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/23010040/adsorption-of-various-antimicrobial-agents-to-endotoxin-removal-polymyxin-b-immobilized-fiber-toraymyxin%C3%A2-part-2-adsorption-of-two-drugs-to-toraymyxin-pmx-20r-cartridges
#7
Ken-ichi Shimokawa, Ryotaro Takakuwa, Yuko Wada, Noriko Yamazaki, Fumiyoshi Ishii
In our previous study, the degree of adsorption of 9 representative antimicrobial agents to Toraymyxin(®) PMX-F sheets was quantitatively evaluated. As a result, the adsorption rate was 22.1% for Linezolid in the presence of serum. Therefore, we investigated whether two types of antimicrobial agents (Ciprofroxacin and Linezolid) can be better adsorbed on PMX-F sheets. When the number of PMX-F sheets was increased in a step wise manner, specifically 2, 4, 6, 8 and 12, the adsorption rate increased linearly...
January 1, 2013: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/22024401/adsorption-of-various-antimicrobial-agents-to-endotoxin-removal-polymyxin-b-immobilized-fiber-toraymyxin%C3%A2
#8
Ken-ichi Shimokawa, Ryotaro Takakuwa, Kumiko Taya, Yuko Wada, Noriko Yamazaki, Masahiro Murata, Kiyotaka Hirata, Tomohiko Masuno, Hiroyuki Yokota, Fumiyoshi Ishii
The presence/absence of adsorption of 9 representative types of antimicrobial agent used in combination with a polymyxin-B immobilized fiber (PMX-F) were determined and the degree of adsorption to PMX-F was quantitatively evaluated. Various antimicrobial agents were dissolved at appropriate concentrations, and PMX-F was added to each solution and incubated at 37°C. Antimicrobial solutions without PMX-F were also similarly incubated as controls. After 2 and 4h, the concentration of each antimicrobial agent was determined using HPLC...
February 1, 2012: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/20519899/mechanisms-of-polymyxin-b-endotoxin-removal-from-extracorporeal-blood-flow-hydrodynamics-of-sorption
#9
G B Fiore, M Soncini, S Vesentini, A Redaelli
The removal of blood endotoxins with the Toraymyxin extracorporeal sorption device exploits the capability of immobilized polymyxin B (PMB) to bind endotoxins stably with a high specificity. Although adsorption is a molecular-scale mechanism, it involves hydrodynamic phenomena in the whole range from the macroscopic down to the supramolecular scales. In this paper we summarize our experience with a computational, multiscale investigation of this device's hydrodynamic functionality. 3D computational fluid dynamics models were developed for the upper-scale studies...
2010: Contributions to Nephrology
https://www.readbyqxmd.com/read/20519898/mechanisms-of-polymyxin-b-endotoxin-removal-from-extracorporeal-blood-flow-molecular-interactions
#10
S Vesentini, M Soncini, G B Fiore, A Redaelli
The outer leaflet of Gram-negative bacteria membrane contains a great amount of lipopolysaccharides, also known as endotoxins, which play a central role in the pathogenesis of septic shock. It has been demonstrated that the polymyxin B (PMB) molecule has both antibacterial and antiendotoxin capabilities; in fact, it is able to compromise the bacterial outer membrane and bind lipopolysaccharides, thereby neutralizing its toxic effects. Extracorporeal hemoperfusion treatments based on cartridges containing PMB-immobilized fibers (Toraymyxin PMX-F; Toray Industries, Tokyo, Japan) are used to remove endotoxins circulating in the blood flow...
2010: Contributions to Nephrology
https://www.readbyqxmd.com/read/20519897/extracorporeal-removal-of-endotoxin-the-polymyxin-b-immobilized-fiber-cartridge
#11
Tohru Tani, Hisataka Shoji, Gualtiero Guadagni, Angelo Perego
Endotoxin, which consists of lipopolysaccharide (LPS), is an outer membrane component of the Gram-negative bacterial cell wall. Endotoxin in the blood stream from an infectious focus or through translocation from the gut plays an important role in the pathogenesis of severe sepsis and septic shock. It binds to monocytes and macrophages, activating them to trigger the production of a variety of mediators. These mediators injure endothelial cells and induce microcirculatory dysfunction. This leads to subsequent organ dysfunction and multiorgan failure...
2010: Contributions to Nephrology
https://www.readbyqxmd.com/read/19684388/preliminary-report-regarding-the-use-of-selective-sorbents-in-complex-cardiac-surgery-patients-with-extensive-sepsis-and-prolonged-intensive-care-stay
#12
M Yaroustovsky, M Abramyan, Z Popok, E Nazarova, O Stupchenko, D Popov, M Plushch, N Samsonova
AIMS: The purpose of this publication is to evaluate the first experiences with the supplemental use of selective endotoxin adsorption cartridges in the treatment of critically ill patients complicated by severe sepsis after cardiac surgery. METHODS: Thirteen patients with Gram-negative sepsis underwent the procedure of selective lipopolysaccharide (LPS) adsorption using Alteco adsorber (group I) or Toraymyxin columns (polymyxin-B-immobilized fiber) (group II). RESULTS: This therapy positively influenced the course of sepsis...
2009: Blood Purification
https://www.readbyqxmd.com/read/19227295/-the-first-experience-in-using-selective-sorbents-in-complex-intensive-care-of-patients-with-infectious-and-septic-complications-after-cardiac-surgery
#13
M B Iarustovskiĭ, M V Abramian, Z V Popok, E I Nazarova, O S Stupchenko, D A Popov, M G Pliushch, N N Samsonova
Early in the new millennium, sepsis remains one of the most urgent problems of modern medicine as before in view of a steady tendency for a rise of morbidity rates and for stably high mortality rates in patients (from 30 to 70%). The endotoxin lipopolysaccharide (LPS) of the cell wall of gram-negative bacteria plays the most important role in the pathogenesis of sepsis. This paper assesses the first experience in using endotoxin-selective sorption technologies within complex intensive care of critically ill patients with infectious and septic complications after cardiac surgery...
November 2008: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/17992653/clinical-effects-of-direct-hemoperfusion-using-a-polymyxin-b-immobilized-column-in-solid-organ-transplanted-patients-with-signs-of-severe-sepsis-and-septic-shock-a-pilot-study
#14
F Ruberto, F Pugliese, A D'Alio, S Martelli, K Bruno, V Marcellino, D Summonti, P Celli, S Perrella, A Cappannoli, C Pietropaoli, A Tosi, B Diana, G Novelli, M Rossi, S Ginanni-Corradini, G Ferretti, P B Berloco, P Pietropaoli
BACKGROUND: Polymyxin B (PMX-B) is a polycationic antibiotic, known to bind the lipid A portion of endotoxin, a cell wall component found exclusively in gram negative bacteria (GNB). An extracorporeal hemoperfusion device (TORAYMYXIN) has been developed: PMX is covalently bound on the surface of an insoluble carrier material so that the endotoxin can be inactivated in the blood without exerting its toxicity on the brain and kidney. The aim of this study was to clarify the efficacy, safety and clinical effects of direct hemoperfusion with an immobilized polymyxin-B fiber column (DHP-PMX) in solid organ transplanted patients with severe sepsis or septic shock...
October 2007: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/17692664/clinical-effects-of-use-polymyxin-b-fixed-on-fibers-in-liver-transplant-patients-with-severe-sepsis-or-septic-shock
#15
F Ruberto, F Pugliese, A D'Alio, S Martelli, K Bruno, V Marcellino, S Perrella, A Cappannoli, V Mazzarino, A Tosi, G Novelli, M Rossi, S Ginanni Corradini, G Ferretti, P B Berloco, P Pietropaoli
UNLABELLED: Polymyxin B (PMX-B) is a polycationic antibiotic, known to bind the lipid A portion of endotoxin, a cell wall component exclusively found in gram-negative bacteria (GNB). An extracorporeal hemoperfusion device (TORAYMYXIN) has been developed: PMX is covalently bound to the surface of an insoluble carrier material to inactivate endotoxin in blood without exerting toxicity on the brain or the kidney. The aim of this study was to evaluate the efficacy, safety, and clinical effects of direct hemoperfusion with an immobilized polymyxin B fiber column (DHP-PMX) among liver transplant patients with severe sepsis or septic shock...
July 2007: Transplantation Proceedings
https://www.readbyqxmd.com/read/17583517/protection-from-endotoxic-shock-by-evk-203-a-novel-alkylpolyamine-sequestrant-of-lipopolysaccharide
#16
Thuan B Nguyen, Ashok Kumar Adisechan, E V K Suresh Kumar, Rajalakshmi Balakrishna, Matthew R Kimbrell, Kelly A Miller, Apurba Datta, Sunil A David
Lipopolysaccharides (LPS) play a key role in the pathogenesis of septic shock, a major cause of mortality in the critically ill patient. The only therapeutic option aimed at limiting downstream systemic inflammatory processes by targeting lipopolysaccharide is Toraymyxin, an extracorporeal hemoperfusion device using solid phase-immobilized polymyxin B (PMB). While PMB is known to effectively sequester LPS, its severe systemic toxicity proscribes its parenteral use, and hemoperfusion may not be feasible in patients in shock...
September 1, 2007: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/17118710/endotoxin-apheresis-for-sepsis
#17
REVIEW
Tomoharu Shimizu, Yoshihiro Endo, Hiroshi Tsuchihashi, Hiroya Akabori, Hiroshi Yamamoto, Tohru Tani
The principle use of apheresis in the treatment of sepsis may be summarized as the removal of toxic substances and the restoration of normal organs function. It is ideal to control the early phases of inflammatory cascade when treating sepsis by removing microbial components, such as endotoxin or peptidoglycan. This review discusses endotoxin apheresis with particular emphasis on treatment using polymyxin B immobilized fiber columns (Toraymyxin) which are used widely in Japan for endotoxin removal therapy in patients with septic shock...
December 2006: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/16552672/multi-scale-analysis-of-the-toraymyxin-adsorption-cartridge-part-ii-computational-fluid-dynamic-study
#18
B Fiore, M Soncini, S Vesentini, A Penati, G Visconti, A Redaelli
Extracorporeal endotoxin removal by means of the Toraymyxin device is based on the ability of polymyxin B to bind endotoxins with a high specificity. The endotoxins/polymyxin molecular interactions were computationally analyzed in a parallel work (Part I). In this paper we investigate with a multi-scale approach the phenomena involving blood and plasma fluid dynamics inside the device. The macro- and mesoscale phenomena were studied by means of 3D models using computational fluid dynamics. The flow behavior in the sorbent material was focused, modeling the sorbent as a homogeneous porous medium at the macroscale level, or accounting for the realistic geometry of its knitted fibers at the mesoscale level...
February 2006: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/16552671/multi-scale-analysis-of-the-toraymyxin-adsorption-cartridge-part-i-molecular-interaction-of-polymyxin-b-with-endotoxins
#19
S Vesentini, M Soncini, A Zaupa, V Silvestri, G B Fiore, A Redaelli
Endotoxins or lipopolysaccharides are the main constituents of the outer leaflet of Gram-negative bacteria membrane and play a central role in the pathogenesis of the septic shock. Polymyxin B has both antibacterial and antiendotoxin capability; indeed it is able to destroy the bacterial outer membrane and bind endotoxin neutralizing its toxic effects. Cartridges containing polymyxin B-immobilized fibers (Toraymyxin PMX-F, Toray Industries, Japan) are used in extracorporeal hemoperfusion to remove circulating endotoxin...
February 2006: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/15834304/a-pilot-controlled-study-of-a-polymyxin-b-immobilized-hemoperfusion-cartridge-in-patients-with-severe-sepsis-secondary-to-intra-abdominal-infection
#20
RANDOMIZED CONTROLLED TRIAL
Jean-Louis Vincent, Pierre-François Laterre, Jonathan Cohen, Hilmar Burchardi, Hajo Bruining, Francisco Alvarez Lerma, Xavier Wittebole, Daniel De Backer, Stephen Brett, Dolores Marzo, Haruji Nakamura, Stephanie John
Endotoxin is an important pathogenic trigger for sepsis. The polymyxin B-immobilized endotoxin removal hemoperfusion cartridge, Toraymyxin (hereafter PMX), has been shown to remove endotoxin in preclinical and open-label clinical studies. In a multicenter, open-label, pilot, randomized, controlled study conducted in the intensive care unit in six academic medical centers in Europe, 36 postsurgical patients with severe sepsis or septic shock secondary to intra-abdominal infection were randomized to PMX treatment of 2 h (n = 17) or standard therapy (n = 19)...
May 2005: Shock
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