Early deaths are likely related to the ongoing CPFA treatment, for reasons that if identified could allow some deaths to be prevented.

We hypothesize a connection to hemodynamic instability consequent on renal replacement therapy that has been shown to increase mortality.

This instability may complicate the said therapy, especially when patients have not been fully stabilized, and may be related to early commencement of treatment (no more than 12h from diagnosis).

Our findings warn about early risk in using CPFA on septic-shock patients, but also highlight uncertainty regarding the effects of CPFA on 90-day mortality.

Before future trials are conducted in this field, the reasons for early deaths should be further investigated.

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