Extracorporeal Therapies for Sepsis and Organ Failure

Extracorporeal therapies encompass a suite of blood purification techniques designed to support failing organs and modulate the dysregulated immune response characteristic of sepsis. By routing blood through external circuits, these approaches remove pathogenic mediators, bacterial products and excess inflammatory cytokines, while in some cases providing organ support such as oxygenation or renal replacement. Modalities include haemoperfusion cartridges that adsorb endotoxins and cytokines, high-volume haemofiltration to enhance convective clearance, and integrated systems combining plasma filtration with adsorption. Recent advances focus on novel sorbent materials with tailored binding properties, hybrid platforms that couple cytokine removal with extracorporeal membrane oxygenation, and smart membranes capable of selective toxin capture. Clinical aims range from restoring immune homeostasis and improving haemodynamics to preventing progression of multiple organ dysfunction. Although promising reductions in inflammatory markers and improvements in surrogate physiological endpoints have been reported, robust evidence for survival benefit remains limited. Current research seeks to define optimal timing, dosage and patient selection, as well as to integrate precision diagnostics for personalised extracorporeal intervention in sepsis and associated organ failure.

Research from Nature Portfolio

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Extracorporeal Therapies for Sepsis and Organ Failure publication trend

The graph below shows the total number of articles in extracorporeal therapies for sepsis and organ failure across all publications each year (not limited to Nature Index journals).

Technical terms

Cytokine storm: An excessive systemic release of signalling proteins that drives widespread inflammation and tissue injury in sepsis.

Hemoadsorption: The process by which circulating inflammatory mediators are captured on sorbent materials as blood passes through an extracorporeal cartridge.

Hemoperfusion: A blood purification technique involving passage of whole blood over adsorptive surfaces to remove toxins, endotoxins or cytokines.

Continuous renal replacement therapy (CRRT): A slow and continuous form of dialysis used in critically ill patients to support kidney function and remove solutes and fluid.

Extracorporeal membrane oxygenation (ECMO): A life-support system that oxygenates blood and removes carbon dioxide via an external membrane lung for patients with severe respiratory or cardiac failure.

References

1. Extracorporeal Catalytic Hemoperfusion Therapy for Refractory Septic Shock Using Ceria Nanoparticle‐Embedded Porous Microbeads. Advanced Functional Materials (2025).
2. Efficacy of CytoSorb®: a systematic review and meta-analysis. Critical Care (2023).
3. CytoSorb in patients with coronavirus disease 2019: A rapid evidence review and meta-analysis. Frontiers in Immunology (2023).
4. Extracorporeal techniques for the treatment of critically ill patients with sepsis beyond conventional blood purification therapy: the promises and the pitfalls. Critical Care (2018).
5. Cytokine removal in human septic shock: Where are we and where are we going?. Annals of Intensive Care (2019).
6. Endotoxin and cytokine reducing properties of the oXiris membrane in patients with septic shock: A randomized crossover double-blind study. PLOS ONE (2019).