Abstract: Endotoxin adsorption therapy with polymyxin B hemoperfusion immobilized fiber column direct hemoperfusion (PMX-DHP) has been used in the treatment of septic shock. Endotoxin is an outer membrane component of Gram-negative bacteria, and plays an important role in the pathogenesis of septic shock. Endotoxin triggers white blood cells, macrophages and endothelial cells to secrete a cascade of signaling mediators including cytokines and nitric oxide, leading to septic shock and multiple organ dysfunction syndrome. PMX-DHP directly adsorbs endotoxin as well as monocytes and monoamides, and reduces blood levels of inflammatory cytokines such as IL-1, IL-6, tumor necrosis factor-α, IL-17A, adhesion molecules, plasminogen activator inhibitor-1, and high mobility group box-1 (HMGB1). PMX-DHP also elevates blood pressure, lowers the dose of vasoactive inotropic drugs, and improves the expression of HLA-DR on monocytes in patients with severe sepsis and septic shock. This article reviews the research progresses in PMX-DHP used in the treatment of septic shock.

Key words: Polymyxin B hemoperfusion immobilized fiber column, Hemoperfusion, Sepsis