Endotoxin (LPS), present in the outer membrane of Gram negative bacteria, is responsible for a series of biological effects, primarily linked to the lipid fraction (Lipid A).The aim of our work was to correlate the endotoxin activity with the risk of severe sepsis in patients showing severe bacterial infection and hospitalized in the three Intensive Care Units of the AUSL BAT. Fifty-three endotoxin activity (EA) blood tests were performed on 28 septic patients. 17/28 (60.7%) patients showed EA > 0.60 (associated with high risk of severe sepsis). Endotoxin activity (EA) blood tests were repeated in 11/17 cases after LPS removal by extracorporeal blood treatment with Polymyxin B (Toraymyxin). 6/11 patients had a reduction of LPS in the bloodstream after 1 treatment with Toraymyxin; in 5 of these 6 patients there was a further reduction after 2 treatments with Toraymyxin. EA dosage has been proven either a method for the diagnosis of severe sepsis due to Gram negative bacteria or helpful means in selecting patients for treatment with Toraymyxin.
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