Sepsis represents an acute syndrome of major interest for intensive care physicians because of significant incidence and severe clinical outcomes. Pathophysiology of sepsis originates from a non-physiological, non-protective, non-adaptive inflammatory response to microbiological threats. Sepsis may be theoretically improved by pharmacological and extracorporeal immune modulating therapies. Pharmacological immune modulation may have long lasting clinical effects, that may even worsen patient-related outcomes. On the other hand, extracorporeal immune modulation allows short-term removal of inflammatory mediators from the bloodstream.