Table 3.
Toraymyxin | Cytosorb | Oxiris | LPS adsorber | HA 330 | |
---|---|---|---|---|---|
Composition | Polymyxin B-immobilized fiber blood-purification column | Porous polymer beads | AN69-based membrane, surface treated with PEI and grafted with heparin | Synthetic polypeptide bound to porous polyethylene discs | Styrene divinylbenzene copolymers |
Indication | Severe sepsis and septic shock | Severe sepsis and septic shock Cardiac surgery with SIRS |
Severe sepsis and septic shock | Severe sepsis and septic shock | Severe sepsis and septic shock |
Toxins removed | Endotoxins | Cytokines/chemokines Anaphylatoxins Myoglobin Free hemoglobin Bilirubin/bile acids Toxins/metals Drugs |
Endotoxin Cytokines |
Endotoxins | Cytokines Complements Free hemoglobin |
Prescription | 2-h session daily for 2 consecutive days | Up to 24-h therapy daily for 2–7 consecutive days | Prescribed dose > 35 ml/kg/h (60% convective). Filter replacement after 24 h or if there is no reduction in VP dose by 50%. Treatment should be stopped if VP are reduced by > 50% or after 3 days of treatment in case of no-response |
2–6 h. One session is usually sufficient to achieve improvement. Repeated procedures can be performed |
2–6 h daily for 2 days |
Blood flow rate (ml/min) | 80–120 | 150–700 | 100–450 | 150 ± 50 | 100–300 |
Anticoagulation | Heparin | Heparin or citrate | Heparin | Heparin | Heparin or citrate |
Additional features | Polymyxin B antimicrobial effect | Largest surface area | Lower risk of thrombogenicity by adsorbing antithrombin-III from the blood |
CRRT continuous renal replacement therapy, LPS lipopolysaccharides, PEI polyethyleneimine, SIRS systemic inflammatory response syndrome, VP vasopressors