The management of critically ill patients is rapidly undergoing change as new technology for the diagnosis, monitoring and treatment of these patients is being utilized. Moreover, the understanding of the pathophysiology of multi-organ failure has greatly increased, a key element in its management involving the support of organ function to allow specific interventions or time for recovery. Originally introduced as an alternative for intermittent hemodialysis, CRRT techniques are now also used for renal support not only in the traditional setting of acute renal failure, but also in other settings as diverse as liver support systems for end-stage liver disease and cancer chemotherapy. This utilization of a common mechanism of blood and plasma membrane interactions is truly an exciting advance, which is likely to be further developed in the next decade. In this multidisciplinary publication, recent advances in our understanding of pathophysiology and critical illness are highlighted.