Administration of anti-TNF antibody improves left ventricular function in septic shock patients. Results of a pilot study.
In this pilot study, murine monoclonal anti-TNF antibody (2 mg/kg) was administered to ten patients within 24 h of septic shock which persisted after initial resuscitation with intravenous fluids and adrenergic agents. This treatment resulted in a reduction in heart rate (from 122 +/- 10 to 113 +/- 10 beats per minute at 4 h, p less than 0.01) associated with an increase in LVSWI (from 26.5 +/- 5.6 to 31.5 +/- 10.5 g.m2 at 2 h, p less than 0.05), indicating in the absence of change in cardiac filling pressures, an improvement in ventricular function. Arterial oxygenation improved concurrently in six patients. These changes, however, appeared transient. The improvement in cardiac function following anti-TNF antibody administration in patients is in keeping with recent experimental studies indicating the role of TNF in the myocardial depression characterizing septic shock.
Vincent
J L
JL
Department of Intensive Care, Erasme University Hospital (Free University of Brussels), Belgium.
Bakker
J
J
Marécaux
G
G
Schandene
L
L
Kahn
R J
RJ
Dupont
E
E
D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012151:Resuscitation; D012772:Shock, Septic / Q000503:physiopathology / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*; D016277:Ventricular Function, Left
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha