Effect of continuous hemofiltration on hemodynamics, lung inflammation and pulmonary edema in a canine model of acute lung injury.
OBJECTIVE
This study examined whether continuous hemofiltration favorably affects cardiopulmonary variables, lung inflammation, and lung fluid balance in a canine model of oleic acid induced acute lung injury.


METHODS
Eleven pentobarbital-anesthetized dogs were randomly divided into a control (mechanical ventilation, MV) group (n=6) and a MV plus hemofiltration (HF) group (n=5). All animals received an intravenous injection of oleic acid (0.09 ml/kg) to induce acute lung injury. Continuous arterial-venous hemofiltration (blood flow 100 ml/min, ultrafiltration rate at 50-65 ml kg(-1) h(-1)) was started after establishment of oleic acid induced acute lung injury and continued for 4 h. Hemodynamics, lung mechanics, gas exchange, lung fluid balance, lung histology, and the level of plasma cytokines were assessed.


RESULTS
After 240 min of HF treatment there was a significant increase in cardiac output, reduction in pulmonary arterial pressure, and improvement in both oxygenation and lung mechanics. Also, in the HF group the lung wet-to-dry weight ratio was significantly reduced. Histologically, HF reduced edema and inflammatory cell infiltration in the lung. There was also a significantly greater decrease in plasma IL-6 and IL-8 levels in the HF group than in group receiving MV alone.


CONCLUSIONS
In a canine model of acute lung injury continuous HF improved cardiopulmonary function, reduced pulmonary edema, decreased lung permeability and inflammation, and decreased the plasma concentration of proinflammatory cytokines.
Su
Xiao
X
Research Institute of Respiratory Diseases, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
Bai
Chunxue
C
Hong
Qunying
Q
Zhu
Duming
D
He
Lixian
L
Wu
Jianping
J
Ding
Feng
F
Fang
Xiaohui
X
Matthay
Michael A
MA
D000418:Albumins / Q000032:analysis; D000704:Analysis of Variance; D000818:Animals; D001706:Biopsy; D001784:Blood Gas Analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D016207:Cytokines / Q000097:blood; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D006439:Hemodynamics; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods*; D008297:Male; D019301:Oleic Acid; D011654:Pulmonary Edema / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D011659:Pulmonary Gas Exchange; D011897:Random Allocation; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D015656:Respiratory Mechanics; D012720:Severity of Illness Index; D016037:Single-Blind Method
D000418:Albumins; D016207:Cytokines; D019301:Oleic Acid