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Gram-negative bacteria, alone or in combination with other organisms, are frequent causes of severe sepsis and septic shock from abdominal infections. Endotoxin is a component on the outer membrane of gram-negative bacteria that is thought to be a key factor in the pathophysiology of gram-negative–induced severe sepsis and septic shock. Polymyxin B, an antibiotic with great affinity for endotoxin, has been bound to polystyrene fibers to create a hemoperfusion device that binds endotoxin. Investigators evaluated this therapy in a prospective, randomized, controlled study of 64 patients with severe sepsis or septic shock who were undergoing surgery for intra-abdominal infection at 10 intensive care units in Italy between December 2004 and Dec…