Effects of long-term hemofiltration on circulating mediators and superoxide production during continuous endotoxin administration.
BACKGROUND
The purpose of this study was to test whether continuous hemofiltration eliminates cytokines and eicosanoids, or stimulates granulocyte function.


METHODS
Nineteen pigs were divided into a control group (n = 7), a hemofiltration group (n = 7), and an extracorporeal circuit only group (n = 5). All animals received the same amount of intravenous endotoxin and resuscitation fluid. Zero-balanced hemofiltration was started 30 minutes after initiation of endotoxemia and continued throughout the experiment. Plasma endotoxin, tumor necrosis factor-alpha, eicosanoids, superoxide production, and other physiologic parameters were measured before challenge and at scheduled intervals thereafter.


RESULTS
Eicosanoids were filtered but plasma concentrations were not reduced. Tumor necrosis factor-alpha was not filtered or adsorbed. There were no significant differences between groups in any measured parameters.


CONCLUSIONS
Continuous hemofiltration could not efficiently remove tumor necrosis factor-alpha or eicosanoids. Also, continuous hemofiltration did not stimulate production of the proinflammatory mediators measured, nor improve respiratory distress.
Ishihara
S
S
U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-5012, USA.
Ward
J A
JA
Tasaki
O
O
Brinkley
W W
WW
Seraile
L G
LG
Pruitt
B A
BA
Mozingo
D W
DW
D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood; D000818:Animals; D004731:Endotoxins / Q000008:administration & dosage*; D004926:Escherichia coli; D005260:Female; D006098:Granulocytes / Q000378:metabolism; D006440:Hemofiltration; D006861:Hydrogen Peroxide / Q000378:metabolism; D018836:Inflammation Mediators / Q000097:blood*; D007262:Infusions, Intravenous; D008070:Lipopolysaccharides / Q000008:administration & dosage; D008168:Lung / Q000473:pathology; D015656:Respiratory Mechanics; D018805:Sepsis / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D013481:Superoxides / Q000378:metabolism*; D013552:Swine; D013929:Thromboxane B2 / Q000097:blood; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D004731:Endotoxins; D018836:Inflammation Mediators; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D013481:Superoxides; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha; C044101:endotoxin, Escherichia coli; D006861:Hydrogen Peroxide