Abstract: Objective  To evaluate the impact of hemoperfusion combined with hemofiltration on inflammatory mediators and prognosis in sepsis through meta-analysis.  Method  A comprehensive literature search was conducted using PubMed, Web of Science, MedLine, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database to collect randomized controlled trials of blood perfusion combined with blood filtration for the treatment of sepsis (observation group treated with blood perfusion combined with blood filtration, control group treated with pure blood filtration). The search was conducted from the establishment of the database until June 30, 2023. Meta-analysis was conducted by using RevMan 5.4 software, and funnel plots were used to analyze the publication bias of various studies.  Results   A total of 19 articles were included, including 1322 patients. Meta-analysis showed that compared to the control group, the observation group had a lower level of C-reactive protein (SMD=-1.60, 95% CI：-2.02～-1.18, P＜0.001), and a lower level of tumor necrosis factor-α (SMD=-1.60, 95% CI：-1.77～ -1.43, P＜0.001), a lower level of interleukin-6 (SMD=-1.29, 95% CI：-1.43～--1.14, P＜0.001), a lower level of sequential organ failure scores (SMD= -0.74, 95% CI：-0.98, -0.51, P＜0.001), and decreased mortality rates (RR=0.50, 95% CI：0.39～ 0.65, P＜0.001).  Conclusion  The combination of hemoperfusion and hemofiltration therapy can downregulate the inflammatory mediators in sepsis, reduce SOFA scores and mortality, and improve prognosis.

Key words: Hemoperfusion, Hemofiltration, Sepsis, Inflammatory mediators