Clinical research has shown that endotoxin is indeed circulating in the blood of up to 50% of sepsis shock patients and associated with impaired clinical outcome. In view of the pivotal role of endotoxin in sepsis patients, the idea of blood purification emerged. Polysterene fiber filters coated with polymyxin B are able to bind endotoxin. A meta-analysis of trials primarily of Japanese origin indicated a survival benefit for patients treated with polymyxin B hemoperfusion. Since then, two randomized trials from Europe and one from USA/Canada have been conducted.

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