Rates of mortality due to sepsis remains high. Endotoxin is the cell wall of gram negative bacteria and it is one of the most major mediators of inflammation in sepsis. Therefore, the measurement of endotoxin in blood is important to select clinical treatment for sepsis/septic shock patients. The standard assay for determination of endotoxin has been the limulus amebocyte lysate assay. However, some reports founded that the usefulness of this assay was limited. Endotoxin activity assay (EAA) is another method for measurement of endotoxin levels in blood. Some studies reported that EAA had a significant correlation with mortality, severity and other biomarkers. Moreover, the EUPHRATES trial showed the possibility that EAA had an usefulness for selecting responsive patient population to PMX-DHP. However, it remains unclear whether EAA is useful for septic patients and we need more research to evaluate its potential. This report serves to present the available knowledge concerning EAA while referencing to previous reports and data from our intensive care units.
