Low-level interventional clinical trial to evaluate the effectiveness and safety of extracorporeal support with hemoperfusion in critical patients with septic multiorgan dysfunction syndrome.

Inclusion Criteria:

• Patients with a sepsis diagnosis, according to the diagnostic criteria of the International Sepsis-3 Consensus Conference, and without response to the treatment of septic shock who meet the following conditions:
• Sepsis of abdominal origin with controlled infectious focus.
• Noradrenaline dose> 0.5 µg / kg / min to maintain adequate organ perfusion after optimization of fluid therapy.
• Dysfunction of two or more organs with SOFA ≥ 9 (5).
• Blood lactate ≥ 2 mmol / L.
• Procalcitonin (PCT)> 10 ng / mL.
• CRP> 100 mg / L.
• IL-6> 2000 pg / ml.

Exclusion Criteria:

• Age under 18 years or over 80 years.
• Pregnancy or breastfeeding.
• Terminally ill patients or with a life expectancy of less than 48 hours.
• Thrombocytopenia <60,000 / mm3.
• Pancytopenia.
• Severe coagulopathy with high risk of bleeding.
• Inclusion in another research protocol.
• In case of re-entry during the study period, only the first admission will be included.
• Use of another haemoperfusion device.

Background Abdominal sepsis remains a major challenge in critical care, often associated with high morbidity and mortality. Hemoadsorption therapy has been proposed as a strategy to modulate the systemic inflammatory response in septic patients. However, clinical evidence in the abdominal sepsis population is limited.

Conclusions Haemoadsorption appears to be a feasible and safe intervention in patients with abdominal sepsis. Preliminary results suggest potential benefits in inflammatory modulation, organ function improvement, and mortality reduction. Larger, more robust clinical trials are required to confirm efficacy and clarify its impact on clinical outcomes. A more comprehensive and detailed analysis of the results will be provided upon completion of the study.