title: Large-pore membrane hemofiltration increases cytokine clearance and improves right ventricular-vascular coupling during endotoxic shock in pigs.
abstract: Hemodynamic improvement in patients suffering from both septic shock and renal failure who received hemofiltration suggested that an extrarenal epuration technique could be of interest in patients with septic shock alone. However, most of the studies using continuous venovenous hemofiltration (CVVH) in this setting evidenced neither cytokine clearance nor significant reduction in their plasma level. Lack of significant clearance was explained in part by the small size of the membrane pores. Therefore, we investigated the effects of large-pore membrane hemofiltration (LPHF) during endotoxic shock in pigs on interleukin 6 (IL-6) and interleukin 10 (IL-10) clearances, and on right ventricular (RV)-vascular coupling. Thirteen anesthetized healthy pigs weighing 20-30 kg were divided into two groups. In the Endo group (n = 6), the pigs received a 0.5-mg/kg endotoxin infusion over a period of 30 mins from T0 to T30. In the EndoHF group (n = 7), LPHF (cutoff = 80 kDa) and an ultrafiltration rate of 45 mL/kg/h were started 30 mins after the end of the endotoxin infusion, from T60 to T240. In this model of porcine endotoxic shock, LPHF was responsible for a significant clearance of IL-6 (20 mL/min) and Il-10 (14 mL/min), and for an improvement in RV-vascular coupling.
authors.affiliation: Department of Medicine, University of Liège, Liège, Belgium. b.lambermont@chu.ulg.ac.be
authors.forename: Bernard
authors.initials: B
authors.lastname: Lambermont
authors.forename: Pierre
authors.initials: P
authors.lastname: Delanaye
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Dogné
authors.forename: Alexandre
authors.initials: A
authors.lastname: Ghuysen
authors.forename: Nathalie
authors.initials: N
authors.lastname: Janssen
authors.forename: Bernard
authors.initials: B
authors.lastname: Dubois
authors.forename: Thomas
authors.initials: T
authors.lastname: Desaive
authors.forename: Philippe
authors.initials: P
authors.lastname: Kolh
authors.forename: Vincent
authors.initials: V
authors.lastname: D'Orio
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Krzesinski
mesh_terms: D000818:Animals; D003331:Coronary Vessels / Q000502:physiology*; D016207:Cytokines / Q000032:analysis / Q000378:metabolism*; D006440:Hemofiltration / Q000379:methods*; D012772:Shock, Septic / Q000503:physiopathology* / Q000601:surgery*; D013552:Swine; D016276:Ventricular Function
chemical_list: D016207:Cytokines