This study is testing if a special treatment called the **PMX cartridge** helps people with **endotoxemic septic shock**. Septic shock is a serious condition where the body has a big reaction to an infection, causing low blood pressure and organ problems. The PMX cartridge is a device that filters the blood to remove harmful substances called endotoxins. People who join the study will either get the usual medical care or the usual care plus the PMX treatment. The PMX treatment involves using the cartridge twice, for about 1½ to 2 hours each time, with a 24-hour gap in between.

Participants must be 18 or older, have low blood pressure needing medicine, and show signs of infection and organ problems. They will have follow-up visits or calls to check on their health up to one year after the study.

• **Duration:** Follow-ups for up to 12 months.
• **Visits:** Includes initial treatment and follow-up calls or visits.
• **Risks:** Must not have certain conditions like severe heart issues or recent injuries.