Clinical applications of oXiris membranes: Targeting inflammation and renal dysfunction in ICU patients

The oXiris membrane represents a notable advance in continuous renal replacement therapy for critically ill patients with severe infection, sepsis, and other conditions characterized by immune dysregulation. Built on a highly adsorptive poly (ethersulfone)/AN69 platform modified to remove inflammatory mediators, endotoxins, and larger molecules, oXiris combines renal support with targeted immunomodulation. In intensive care settings it has been used for sepsis and septic shock, intra-abdominal infection, cardiogenic shock (including during veno-arterial extracorporeal membrane oxygenation, VA-ECMO), acute kidney injury, and selected autoimmune disorders. Observational studies and small trials suggest improved hemodynamic stability, reduced vasopressor requirements, and decreases in circulating cytokines and endotoxin. Sequential extracorporeal therapy combining oXiris with other devices (e.g., CytoSorb, Seraph-100, Toraymyxin) may further potentiate these effects. Evidence from large, randomized trials remains limited, and questions persist regarding patient selection, timing, and cost-effectiveness. This narrative review summarizes the membrane's technical features and mechanisms of action, synthesizes available clinical data across major indications, and outlines current limitations and research priorities.