Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Sepsis

Clearing the blood in sepsis

The recent EUPHAS trial was stopped early because of reduced mortality in patients with sepsis treated with polymyxin B hemoperfusion. So should we rush to offer this technique to all patients with sepsis? Not quite so fast.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Methods for the extracorporeal elimination of inflammatory mediators.

References

  1. Vincent, J. L. et al. Sepsis in European intensive care units: results of the SOAP study. Crit. Care Med. 34, 344–353 (2006).

    Article  PubMed  Google Scholar 

  2. Kellum, J. A. & Bellomo, R. Hemofiltration in sepsis: where do we go from here? Crit. Care 4, 69–71 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Palevsky, P. M. et al. Intensity of renal support in critically ill patients with acute kidney injury. N. Engl. J. Med. 359, 7–20 (2008).

    Article  CAS  PubMed  Google Scholar 

  4. Payen, D. et al. Impact of continuous venovenous hemofiltration on organ failure during the early phase of severe sepsis: a randomized controlled trial. Crit. Care Med. 37, 803–810 (2009).

    Article  PubMed  Google Scholar 

  5. Rogiers, P. et al. Blood warming during hemofiltration can improve hemodynamics and outcome in ovine septic shock. Anesthesiology 104, 1216–1222 (2006).

    Article  PubMed  Google Scholar 

  6. Marshall, J. C. et al. Diagnostic and prognostic implications of endotoxemia in critical illness: results of the MEDIC study. J. Infect. Dis. 190, 527–534 (2004).

    Article  CAS  PubMed  Google Scholar 

  7. Cruz, D. N. et al. Effectiveness of polymyxin B-immobilized fiber column in sepsis: a systematic review. Crit. Care 11, R47 (2007).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Vincent, J. L. et al. A pilot-controlled study of a polymyxin B-immobilized hemoperfusion cartridge in patients with severe sepsis secondary to intra-abdominal infection. Shock 23, 400–405 (2005).

    Article  CAS  PubMed  Google Scholar 

  9. Cruz, D. N. et al. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA 301, 2445–2452 (2009).

    Article  CAS  PubMed  Google Scholar 

  10. Kellum, J. A. & Uchino, S. International differences in the treatment of sepsis: are they justified? JAMA 301, 2496–2497 (2009).

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean-Louis Vincent.

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vincent, JL. Clearing the blood in sepsis. Nat Rev Nephrol 5, 559–560 (2009). https://doi.org/10.1038/nrneph.2009.146

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2009.146

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing