Endotoxin apheresis for sepsis

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. Lixelle® and CTR which have recently been shown to remove circulating bacterial components are also included in this review.