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Peer-reviewedCC BYCritical care (London, England)

Polymyxin B hemoadsorption in endotoxic septic shock: ten questions on the Tigris trial.

  • Matthieu Legrand1
  • Javier Neyra2
  • George Tomlinson3
  • John A Kellum4,5
5 affiliations
  1. 1Department of Anesthesia and Perioperative Care, Division of Critical Care Medicine, University of California, 521 Parnassus Avenue, San Francisco, CA, 94143, USA. [email protected].
  2. 2Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA.
  3. 3Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  4. 4Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
  5. 5Spectral Medical Inc, Toronto, ON, Canada.
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Abstract

The Tigris trial recently reported that polymyxin B hemoadsorption (PMX) achieved a high posterior probability of benefit for mortality in adults with endotoxic septic shock (endotoxemia with multiple organ failure). The trial used a Bayesian framework with a prior derived from a subgroup of an earlier trial (EUPHRATES) and this subgroup was used to design eligibility criteria for Tigris. Ten questions that expose the trial's strengths and limitations are answered in this review. Writing as the trial investigators, our intention is to make the reasoning behind these decisions explicit, so that clinicians and trialists can judge what Tigris does, and does not, demonstrate.

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Cite

BibTeXRIS
BibTeX
@article{legrand2026polymyxin,
  title = {{Polymyxin B hemoadsorption in endotoxic septic shock: ten questions on the Tigris trial.}},
  author = {Matthieu Legrand and Javier Neyra and George Tomlinson and John A Kellum},
  journal = {Critical care (London, England)},
  year = {2026},
  month = aug,
  doi = {10.1186/s13054-026-06219-y},
  url = {https://europepmc.org/article/MED/42839288},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Polymyxin B hemoadsorption in endotoxic septic shock: ten questions on the Tigris trial.
AU  - Matthieu Legrand
AU  - Javier Neyra
AU  - George Tomlinson
AU  - John A Kellum
PY  - 2026
DA  - 2026/08/27
JO  - Critical care (London, England)
DO  - 10.1186/s13054-026-06219-y
UR  - https://europepmc.org/article/MED/42839288
AB  - The Tigris trial recently reported that polymyxin B hemoadsorption (PMX) achieved a high posterior probability of benefit for mortality in adults with endotoxic septic shock (endotoxemia with multiple organ failure). The trial used a Bayesian framework with a prior derived from a subgroup of an earlier trial (EUPHRATES) and this subgroup was used to design eligibility criteria for Tigris. Ten questions that expose the trial's strengths and limitations are answered in this review. Writing as the trial investigators, our intention is to make the reasoning behind these decisions explicit, so that clinicians and trialists can judge what Tigris does, and does not, demonstrate.
SN  - 1364-8535
SN  - 1466-609X
ER  -