[Effects of high-volume continuous hemofiltration on inflammatory reaction in experimental porcine pancreatitis in pig].
OBJECTIVE
To investigate the effect of high-volume continuous hemofiltration on inflammatory reaction in experimental severe acute pancreatitis (SAP) in pigs.


METHODS
SAP was reproduced in pigs by intraductal injection of sodium taurocholate and trypsin, and they were randomly divided into three groups. Control group consisted of animals with SAP running its spontaneous course. Low-volume continuous venovenous hemofiltration (CVVH) group animals received a low volume (20 ml.kg(-1).h(-1)) CVVH, and high-volume CVVH group animals received a high volume (100 ml.kg(-1).h(-1)) CVVH both started at the onset of SAP. Vital signs were monitored. The serum concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-10, and activated nuclear factor-kappaB (NF-kappaB) levels of peripheral blood mononuclear cell were determined at 0, 6, 12, 24, and 36 hours after the onset of SAP.


RESULTS
The median survival time of control, low-volume and high-volume CVVH groups was respectively 41 hours, 50 hours and 65 hours. Survival time of the latter two groups was significantly higher than that in control group (P<0.05 and P<0.01), and the survival time of animals in high-volume CVVH group was significantly higher than low-volume CVVH (P<0.05). In the high-volume CVVH group, plasma contents of TNF-alpha, IL-6 and IL-10 were lower significantly than in the low-volume CVVH and control groups from the beginning to the end of the experiment. In high-volume CVVH group, the expressions of NF-kappaB activation at 6, 12 and 24 hours were lower than those in the control and low-volume CVVH groups respectively.


CONCLUSIONS
Early CVVH can blunt the excessive inflammatory reaction in experiment porcine pancreatitis in pigs, obviously prolong survival time, and improve prognosis. High-volume CVVH is significantly efficacious compared with low-volume CVVH in these respects.
Yan
Xiao-wen
XW
Surgical Intensive Care Unit, Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China. yan_xiaowen@yahoo.com.cn
Li
Wei-qin
WQ
Wang
Hao
H
Zhang
Zhen-huan
ZH
Li
Jie-shou
JS
Li
Ning
N
D000818:Animals; D004195:Disease Models, Animal; D006440:Hemofiltration; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016328:NF-kappa B / Q000097:blood; D010195:Pancreatitis / Q000097:blood* / Q000628:therapy; D011897:Random Allocation; D013552:Swine; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015850:Interleukin-6; D016328:NF-kappa B; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10