S epsis is an infl ammation syndrome which is caused by severe infection. This severe infl ammation is characterized by vasodilatation, leukocyte accumulation and increased microvascular permeability. The pathophysiology of sepsis is believed to be due to the dysregulation of the infl ammatory response. The human body generates and releases a massive uncontrolled amount of proinfl ammatory mediators into the blood stream which causes cellular and tissue injury. This injury leads to the development of multiple organ dysfunction syndromes (MODS), and causes life-threatening conditions. The normal host response to infection involves the activation of circulating and fi xed phagocytic cells, the generation of proinfl ammatory and anti-infl ammatory mediators. When the body releases massive cytokines beyond the infection site, sepsis occurs. These mediators cause fever, hypotension, acute phase protein response, induction of interleukin 6, coagulation activation, increased endothelial permeability and so on. These large quantities of proinfl ammatory mediators will cause cellular damage and lead to multiple organ failure.In conventional therapy for sepsis, the priority is to eradicate infection by using appropriate antibiotics and surgical interventions, and to initiate supportive care in order to correct physiologic abnormalities such as hypoxemia and hypotension. 1-4 Despite optimal treatment and close monitoring in intensive care units, the mortality rate due to severe sepsis and septic shock is approximately 40% and can exceed 50% in the sickest patient. [5][6][7][8] A study from Nakada TA, et al. 9 in 2008 showed a decrease of interleukin 6 and procalcitonin correlated with survival during sepsis. The innovative idea to reduce proinfl ammatory cytokines led to the development of the extracorporeal blood purifi cation technique. Extracorporeal blood purifi cation can be performed in different ways. The treatment restores the normal balance of the targeted substances within the patient's body.Coupled plasma fi ltration adsorption (CPFA) is a therapeutic extracorporeal blood purifi cation tool combining 3 techniques namely plasma fi ltration, adsorption and hemofi ltration. CPFA is suitable for illnesses involving renal failure together with large molecules, especially if these have a molecular weight close to that of albumin such as infl ammatory substances found in sepsis and in liver failure. The CPFA technique has been performed in animal experimentation and in clinical settings worldwide since 1998. Some CPFA studies have been reviewed (Table 1).
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