Qiang Zhou, Jun Lin
Continuous blood purification (CBP) has been widely employed in adult sepsis management. However, given the distinct aetiology and host responses in paediatric sepsis compared to adults, the application of CBP in children remains under-researched in high-quality systematic studies, particularly regarding its efficacy in clearing inflammatory cytokines. This meta-analysis aims to evaluate the therapeutic efficacy of CBP in paediatric sepsis patients and its impact on inflammatory cytokines. This study systematically analysed randomized controlled trials and prospective cohort studies of CBP in paediatric sepsis from January 1990 to October 2025. Studies were retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Outcomes included inflammatory markers and prognostic markers. This meta-analysis included 6 studies. Pooled results demonstrated that CBP reduced 28-day mortality (OR = 0.57, 95% CI: 0.30 to 1.07), PICU length of stay (OR = -0.06, 95% CI: -1.55 to 1.43), IL-6 (OR = 0.83, 95% CI: 0.14 to 1.53), CRP (OR = 1.26, 95% CI: -16.51 to 19.03), and TNF-α (OR = 1.66, 95% CI: -0.39 to 3.77). CBP reduced the level of inflammatory markers and improved prognosis, which may provide evidence for the use of CBP in paediatric sepsis patients.