Blood puriWcation therapy for sepsis

Accumulating evidences of underlining pathogenesis of sepsis have contributed to the therapeutic strategy for sepsis. Not only endotoxin and cytokine, but also signal transduction through Toll-like receptors could be a strategic target for the management of sepsis. Blood puriWcation therapy including polymyxin B-immobilized hemoperfusion cartridge and continuous hemodiaWltration has shown the beneWcial eVect on patients with sepsis in Japan. Although they were initially designed to remove endotoxin and cytokines respectively, they might eliminate unexpected mediators responsible for sepsis. Further elucidation of mechanism and randomized controlled studies are needed to establish the role of blood puriWcation therapy in sepsis.