Continuous venovenous hemofiltration: effects on monocyte and lymphocyte immunophenotype in critically ill patients.
The aim of this study was to test the hypothesis that continuous venovenous hemofiltration (CVVH) increases HLA-DR expression on monocytes and T lymphocytes in critically ill patients. 24 septic (SP) and 10 non-septic (NSP) medical ICU patients with acute renal failure were studied prospectively. The ultrafiltration rate was 20-30 ml.kg(-1).h(-1). The total and differential white cell counts were measured and CD3+ lymphocyte count, HLA-DR expression on CD14+ monocytes and CD3+ lymphocytes were analysed by two-colour flow cytometry before, 4 and 24 h after CVVH initiation, respectively. CVVH did not influence leukocyte, granulocyte, total lymphocyte and CD3+ lymphocyte counts in both groups of patients. The percentage of HLA-DR+/CD14+ monocytes in SP revealed no changes, whereas it decreased after 4 h of CWH in NSP (p < 0.05). The percentage of HLA-DR+/CD3+ lymphocytes in SP decreased after 24 h (p < 0.05), whereas it remained unchanged in NSP. We conclude that CWH initiation is not associated with the increase of HLA-DR expression on CD14+ monocytes and T lymphocytes in critically ill patients with acute renal failure.
Rokyta
R
R
ICU, Department of Internal Medicine I, Charles University Hospital Plzen, Czech Republic. rokyta@fnplzen.cz
Holub
M
M
Matĕjovic
M
M
Hanzlíková
J
J
Helcl
M
M
Novák
I
I
Srámek
V
V
Krouzecky
A
A
Príhodová
J
J
D018806:APACHE; D058186:Acute Kidney Injury / Q000276:immunology* / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D017252:CD3 Complex / Q000276:immunology*; D016022:Case-Control Studies; D016638:Critical Illness; D005260:Female; D006684:HLA-DR Antigens / Q000276:immunology*; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D018950:Lipopolysaccharide Receptors / Q000276:immunology*; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000276:immunology / Q000401:mortality / Q000628:therapy; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome
D017252:CD3 Complex; D006684:HLA-DR Antigens; D018950:Lipopolysaccharide Receptors