Recent advances in membrane and sorbent design for blood purification in sepsis and septic shock

<h2>Summary</h2> Being one of the foremost causes of morbidity and mortality, sepsis represents a significant global health challenge. The condition is instigated by pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs), which contribute to the elevation of cytokines and can ultimately result in multiorgan failure. Extracorporeal blood-purification therapy has been proposed as a strategy for eliminating inflammatory mediators. Recent advancements in membrane and sorbent technology have broadened the range of available therapeutic devices. Modified continuous veno-venous hemofiltration (CVVH) membranes, characterized by increased porosity (high-cutoff membranes) or enhanced adsorptive properties (e.g., AN69-ST and AN69 oXiris), can improve the efficacy of the removal process. Hemoadsorption devices utilize sorbents to extract pathogens, toxins, and inflammatory mediators from the bloodstream. Nonetheless, the current evidence does not substantiate widespread clinical application. There exists an urgent need for further innovations in membrane design and adsorbent materials. Well-structured prospective clinical trials are also essential.