Extracorporeal Endotoxin Removal For The Treatment of Sepsis:Endotoxin Adsorption Cartridge (Toraymyxin)

@article{Shoji2003ExtracorporealER,
  title={Extracorporeal Endotoxin Removal For The Treatment of Sepsis:Endotoxin Adsorption Cartridge (Toraymyxin)},
  author={Hisataka Shoji},
  journal={Therapeutic Apheresis and Dialysis},
  year={2003},
  volume={7}
}
  • H. Shoji
  • Published 1 February 2003
  • Medicine, Biology
  • Therapeutic Apheresis and Dialysis
Abstract:  Toray Industries Inc. has developed an endotoxin removalcartridge (Toraymyxin) composed of a polymyxin B immobilized, fibrousadsorbent. Toraymyxin has been listed as a blood purification medicaldevice for endotoxin removal to be reimbursed by the Japanese nationalhealth insurance since 1994. Toraymyxin can be applied to patientswith endotoxemia or suspected gram‐negative infection, which fulfilllthe conditions of Systemic Inflammatory Response Syndrome (SIRS)and have septic shock… 
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192 Citations
Highly Influential Citations
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Background Citations
51
Methods Citations
23
Results Citations
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192 Citations

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Endotoxin adsorption: Direct hemoperfusion with the polymyxin B-immobilized fiber column (PMX).
Extracorporeal removal of endotoxin: the polymyxin B-immobilized fiber cartridge.
TLDR
PMX is a selective blood endotoxin removal cartridge composed of polymyxin B covalently bonded to polystyrene-derivative fibers that has a strong affinity to endotoxin and is able to bind the lipid A portion of endotoxin through ionic and hydrophobic interactions.
Clinical effects of polymyxin B-immobilized fiber column in septic patients.
TLDR
Preliminary results suggest direct hemoperfusion with polymyxin-B-immobilized fiber with PMX-F therapy appears to significantly lower endotoxin levels, improve blood pressure, and reduce mortality, however, publication bias and lack of blinding need to be considered.
History and current status of polymyxin B‐immobilized fiber column for treatment of severe sepsis and septic shock
TLDR
It is revealed that PMX significantly decreased mortality in patients with severe sepsis and septic shock, and Combination of PMX with continuous hemodiafiltration and longer duration of PMx might be an effective strategy to improve survival in such patients.
Commentary A targeted extracorporeal therapy for endotoxemia: the time has come
TLDR
A meta-analysis examining a novel treatment of sepsis and septic shock predicated on the removal of endotoxin from the bloodstream finds that polymyxin B hemoperfusion may have favorable effects on survival and hemodynamics.
Endotoxin removal devices for the treatment of sepsis and septic shock.
Efficacy of polymyxin B-immobilized fiber hemoperfusion for patients with septic shock caused by Gram-negative bacillus infection
TLDR
It is concluded that PMX-based endotoxin adsorption within 24 hours from ICU admission was not associated with mortality among patients with septic shock due to GNB.
Use of an endotoxin adsorber in the treatment of severe abdominal sepsis
TLDR
LPS adsorption may represent a significant improvement in the treatment of Gram‐negative sepsis and further studies are planned.
Endotoxin Removal: History of a Mission
  • C. Ronco
  • Medicine, Biology
    Blood Purification
  • 2014
TLDR
This review will outline the meaning of the targeted approach to endotoxin, both highlighting the specific immunologic effect of endotoxin removal by polymyxin B and the evidence of clinical improvements following this kind of therapy in terms of recovery of organ function.
Effect Over Time of Endotoxin Adsorption Therapy in Sepsis
TLDR
It is concluded that PMX‐DHP is expected to have important implications in terms of correction of clinical conditions; improvement of hemodynamics; possible anti‐inflammatory effect; and possible improvement of oxygen metabolism in tissues.
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