Épuration extra-corporelle et immunomodulation dans le sepsis

Septic shock is common and represents the leading cause of death in intensive care. Despite internationally updated (Surviving Sepsis Campaign) recommendations and advances in resuscitation, mortality remains very high (up to 40%), partly because of the consequences of the immuno-inflammatory host response dysregulated. The physiopathological rationale for extracorporeal blood purification techniques in septic shock is based on better control of this host response. Many techniques are proposed, some combining the elimination of cytokines and / or endotoxins with renal remplacement therapy.The scientific literature is relatively important about this subject. Large recent multicenter clinical trials do not support promising experimental and preclinical results. Experimental and clinical research should continue in this area. We propose in this article a review of the literature of different extracorporeal blood purification techniques in septic shock.