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Extracorporeal endotoxin removal in a canine model of septic shock.

The authors induced endotoxic shock in an animal model and attempted to treat this state by direct hemoperfusion over a modified anion sorbent column. It has been shown that the reversal of septic shock correlates with the efficiency of extracorporeal endotoxin removal. In this experiment, there were five control animals (sham) and five test animals (hemoperfusion over sorbent column). The efficacy of treatment was evaluated by survival at 24 hr, changes in mean arterial pressure, blood-acid base balance, and plasma endotoxin levels. There was 0% survival in the control group and 100% survival in the test group. The control dogs never recovered from shock or metabolic acidosis, but the test animals were at their initial values for these parameters by 6 hr. The endotoxin levels measured at 6 hr were higher in the control group (265 +/- 88 ng/ml) as compared with the test group (7.0 +/- 6.2 ng/ml). Direct hemoperfusion over a modified sorbent column effectively removed endotoxin and reversed the course of fatal septic shock.