Inclusion Criteria:  Gram-negative agents in the blood; or detection of an infection focus suggesting Gram-negative agents; or suspected infection based on patient condition, presence of at least two criteria for a systemic inﬂammatory response and procalcitonin (PCT) level ≥ 2 ng/ml; severity of organ dysfunction assessed on a Sepsis-related Organ Failure Assessment (SOFA) scale > 4 points as a result of an evident or suspected infection; need for vasopressor support after administration of ﬂuids to maintain an average blood pressure of at least 65 mmHg. and lactate level in serum > 2 mmol/l (optional, for diagnosis of septic shock).  An additional criterion was the endotoxin activity exceeding 0.6 units according to EAA  Exclusion Criteria:  terminal condition, ongoing internal bleeding or high risk of bleeding, severe heart failure (left ventricular ejection fraction < 25%), decompensated liver failure, body weight less than 20 kg, age < 18 or > 80 years.