title: Amelioration of hemodynamics and oxygen metabolism by continuous venovenous hemofiltration in experimental porcine pancreatitis.
abstract: OBJECTIVE
  To investigate the potential role of continuous venovenous hemofiltration (CVVH) in hemodynamics and oxygen metabolism in pigs with severe acute pancreatitis (SAP).
  
  
  METHODS
  SAP model was produced by intraductal injection of sodium taurocholate (4%, 1 mL/kg body weight (BW)) and trypsin (2 U/kg BW). Animals were allocated either to untreated controls as group 1 or to one of two treatment groups as group 2 receiving a low-volume CVVH (20 mL/(kg.h)), and group 3 receiving a high-volume CVVH (100 (mL/kg.h)). Swan-Ganz catheter was inserted during the operation. Heart rate, arterial blood pressure, cardiac output, mean pulmonary arterial pressure, pulmonary arterial wedge pressure, central venous pressure, systemic vascular resistance, oxygen delivery, oxygen consumption, oxygen extraction ratio, as well as survival of pigs were evaluated in the study.
  
  
  RESULTS
  Survival time was significantly prolonged by low-volume and high-volume CVVHs, which was more pronounced in the latter. High-volume CVVH was significantly superior compared with less intensive treatment modalities (low-volume CVVH) in systemic inflammatory reaction protection. The major hemodynamic finding was that pancreatitis-induced hypotension was significantly attenuated by intensive CVVH (87.4+/-12.5 kPa vs 116.3+/-7.8 kPa, P<0.01). The development of hyperdynamic circulatory failure was simultaneously attenuated, as reflected by a limited increase in cardiac output, an attenuated decrease in systemic vascular resistance and an elevation in oxygen extraction ratio.
  
  
  CONCLUSIONS
  CVVH blunts the pancreatitis-induced cardiovascular response and increases tissue oxygen extraction. The high-volume CVVH is distinctly superior in preventing sepsis-related hemodynamic impairment.
authors.affiliation: Department of Nephrology, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.forename: Zhen-Huan
authors.initials: ZH
authors.lastname: Zhang
authors.forename: Xiao-Wen
authors.initials: XW
authors.lastname: Yan
authors.forename: Wei-Qin
authors.initials: WQ
authors.lastname: Li
authors.forename: Da-Xi
authors.initials: DX
authors.lastname: Ji
authors.forename: Zhu-Fu
authors.initials: ZF
authors.lastname: Quan
authors.forename: De-Hua
authors.initials: DH
authors.lastname: Gong
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D000208:Acute Disease; D000681:Amylases / Q000097:blood; D000818:Animals; D001794:Blood Pressure; D002496:Central Venous Pressure; D006440:Hemofiltration; D009102:Multiple Organ Failure / Q000517:prevention & control; D010101:Oxygen Consumption; D010195:Pancreatitis / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D034421:Sus scrofa
chemical_list: D000681:Amylases