Objective To compare the therapeutic effects of high volume hemofiltration(HVHF) and coupled plasma filtration absorption(CPFA) on sepsis patients with multiple organ dysfunction syndromes(MODS) or multiple organ failure in the elderly(MOFE).Methods Fourteen sepsis patients complicated with MODS were enrolled and randomly divided into HVHF and CPFA groups.The two groups respectively received 10 h of HVHF or CPFA treatment.The primary endpoints were changes in hemodynamic effects,electrolytes and acid-base balance,sepsis-related organ failure assessment(SOFA) score and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score after pulse HVHF or CPFA.Results(1) After the therapies,blood urea nitrogen(BUN) and serum creatinine(Cr) all significantly decreased,electrolytes and acid-base balance were well maintained,and no visible influence was found in white blood cell count,platelet or hematocrit.(2) After CPFA,SOFA score and APACHEⅡscore decreased dramatically(P<0.05),mean arterial pressure(MAP) and oxygenation index(PaO2/FiO2) showed significant improvement(P<0.05).However,after HVHF,only SOFA score was markedly decreased(P<0.05),no significant differences were found in MAP,oxygenation index or APACHEⅡ score(P>0.05).(3) No therapy related adverse reactions such as hemorrhage,hypersensitiveness or embolism were noted even in the aged during the two treatments.(4) Seven days after therapies,4 patients survived in the HVHF group and 6 survived in the CPFA group.Conclusion Both HVHF and CPFA therapies improve the clinical manifestations of sepsis patients with MODS,and the effect of CPFA is superior to HVHF.