• D Pestaña, N Ojeda, O M Padrón, E Higuera, T Rey, C Aldecoa, and del Grupo de Trabajo de Insuficiencia Renal Perioperatoria de la sección de Cuidados Intensivos de la SEDAR.
• Servicio de Anestesiología y Reanimación, Hospital Universitario Ramón y Cajal, Madrid, España. dpestana.hulp@salud.madrid.org
• Rev Esp Anestesiol Reanim. 2013 Jun 1; 60 (6): 336-43.

AbstractHaemoperfusion is an extracorporeal technique that removes endotoxin and/or inflammatory mediators by means of an adsorptive mechanism during the passage of the blood through a porous filter. Most of the studies in the literature use polymyxin B as the adsorptive agent. This treatment is based on the assumption that the removal of endotoxin and inflammatory mediators from the circulation attenuates the inflammatory response in sepsis. This review summarizes the theoretical basis, and the experimental and clinical results published to date with the use of haemoperfusion. Although most of the studies show positive results, some doubts have arisen about the suitability of the methods described (small number of cases, low quality of the experimental design, and excessive mortality in the control groups). There are also some inconsistencies regarding the theoretical basis of its use (lack of positive effects after the removal of endotoxin from the circulation using alternative mechanisms, discrepancies regarding the best moment to initiate the therapy, unexplained beneficial effects in the absence of increased endotoxin levels). It is the opinion of the authors that haemoperfusion represents a promising therapy for the treatment of sepsis, but consider that its usefulness requires confirmation in well designed studies before being included in protocols.Copyright © 2011 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

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