[Endotoxin adsortion as adjuvant therapy in gram negative severe sepsis]. / La depuración de endotoxina como tratamiento coadyuvante en la sepsis grave por microorganismos gramnegativos.

The mortality rate of severe sepsis and septic shock remains still high. Within the last years a better knowledge of its physiopathology and the implementation of a group of measures addressed to a fast identification and early treatment of the septic patients have proved to reduce mortality rate. Likewise, it continues being investigated in modulating the inflammatory response and limiting the harmful action of the bacterial products on the immune system. As a result of this research some endotoxin adsorber devices have been designed to control one of the most important targets that start the inflammatory cascade when gram negative microorganisms are involved.The usefulness that these endotoxin removal devices might have as adjuvant treatment in the Septic Syndrome and its applicability are reviewed in this paper. Likewise a profile of patient that might be to the benefit of this therapy is suggested according to the current knowledge.

La depuracion de endotoxina como tratamiento coadyuvante en la sepsis grave por microorganismos gramnegativos / Endotoxin adsortion as adjuvant therapy in gramnegative severe sepsis

La sepsis grave y el shock séptico siguen siendo situaciones clínicas con alta mortalidad. En los últimos años, un mejor conocimiento de su fisiopatología y la puesta en marcha de un conjunto de medidas encaminadas a una rápida detección y un inmediato tratamiento de los pacientes sépticos han demostrado que pueden disminuir la mortalidad. Así mismo, se sigue investigando en modular la respuesta inflamatoria y limitar la acción dañina de los productos bacterianos sobre el sistema inmune. Fruto de esta investigación se han desarrollado dispositivos adsorbentes de endotoxina para actuar sobre ella por ser ésta una de las principales dianas que inician la cascada inflamatoria en infecciones causadas por gérmenes gramnegativos. En este artículo se revisa la utilidad y modo de empleo que estos dispositivos de depuración de endotoxinas pueden tener como tratamiento coadyuvante del Síndrome séptico. Así mismo se sugiere, en base a los conocimientos actuales, el perfil de paciente que puede beneficiarse de dicha terapia(AU)

The mortality rate of severe sepsis and septic shock remains still high. Within the last years a better knowledge of its physiopathology and the implementation of a group of measures addressed to a fast identification and early treatment of the septic patients have proved to reduce mortality rate. Likewise, it continues being investigated in modulating the inflammatory response and limiting the harmful action of the bacterial products on the immune system. As a result of this research some endotoxin adsorber devices have been designed to control one of the most important targets that start the inflammatory cascade when gramnegative microorganisms are involved. The usefulness that these endotoxin removal devices might have as adjuvant treatment in the Septic Syndrome and its applicability are reviewed in this paper. Likewise a profile of patient that might be to the benefit of this therapy is suggested according to the current knowledge(AU)