TY  - JOUR
T1  - Hemoadsorption for Burn-induced Immune Dysregulation: Mechanisms, Evidence, and Perspectives 
AU  - Chardon, Nicolas
AU  - Bidar, Frank
AU  - Abraham, Paul
AU  - Payen, Didier
AU  - Rimmelé, Thomas
JF  - Journal of Translational Critical Care Medicine
VL  - 8
IS  - 3
SN  - 2590-3438
SP  - e00004
EP  - e00004
Y1  - 2026-09-30
DO  - 10.14218/JTCCM.2026.00017
UR  - https://www.xiahepublishing.com/2590-3438/JTCCM-2026-00017
AB  - Extensive burn injuries are associated with a profound systemic response, the severity of which increases with the extent of tissue damage. Beyond local destruction, extensive burns induce a sustained immune-inflammatory disturbance that alters immune regulation and contributes to secondary organ failure and infectious complications. These mechanisms are major determinants of adverse outcomes in critically ill patients with burns. In this context, therapeutic strategies targeting immune dysregulation have gained increasing attention. Immunomodulatory approaches aim to limit excessive inflammatory signaling while maintaining effective host defense. Among extracorporeal blood purification techniques, hemoadsorption has emerged as a potential adjunctive therapy designed to reduce circulating inflammatory mediators, particularly cytokines, and to attenuate systemic inflammatory burden. Rather than providing another general overview of extracorporeal blood purification, this review focuses specifically on the cellular and mechanistic basis of burn-induced immune dysregulation and offers a stratified, critical appraisal of the experimental and clinical evidence for hemoadsorption in burns, together with current safety considerations and unresolved questions that should guide future research. Experimental studies and early clinical observations suggest that hemoadsorption may contribute to hemodynamic stabilization and modulation of inflammation in critically ill patients, including those with severe burns. However, clinical evidence in this specific population remains scarce, and its impact on patient-centered outcomes has not yet been established. Although available data suggest that this technique is generally well tolerated, the non-selective removal of circulating molecules underscores the need for careful patient selection and close monitoring. Future investigations should focus on defining the appropriate indications, optimal timing, and treatment duration of hemoadsorption for burn care. Comparative studies with other immunomodulatory strategies are required to clarify its role within the therapeutic armamentarium for burn-induced immune dysfunction.