[Effect of continuous veno-venous hemofiltration on the plasma level of cytokines in patients with multiple organ dysfunction syndrome].
OBJECTIVE
To investigate the effect of CVVH on the plasma levels of TNF-alpha, IL-1, IL-6, IL-8 in patients with multiple organ dysfunction syndrome (MODS).


METHODS
Twenty-two patients with MODS were treated with continuous veno-venous hemofiltration (CVVH), venous and arterial blood samples were taken at 0, 1, 4, 8 hour following CVVH and ultrafiltration fluid samples were taken at 8 hour following CVVH. Arterial blood samples were used for blood gas analysis, venous blood samples and ultrafiltration fluid were used to measure the levels of cytokines by ELISA.


RESULTS
The plasma levels of TNF-alpha and IL-1 were significantly decreased following CVVH (P < 0.05). The IL-1, IL-6, IL-8 were detected in the ultrafiltration fluid and TNF-alpha was not. Heart rate decreased and mean arterial pressure (MAP) increased significantly 4 hrs after CVVH (P < 0.05). PaO(2)/FiO(2) increased significantly (P < 0.05). The APACHE II scores reduced after CVVH (P < 0.05). The reduction of APACHE II score and the elimination of cytokines were positively correlated with ultrafiltration flow rates


CONCLUSIONS
CVVH can remove some cytokines in plasma, reduce APACHEII score and improve hemodynamics and oxygenation in MODS. Moreover, higher volume hemofiltration has better effect on the elimination of cytokines and can further improve the prognosis of MODS.
Kou
Qiu-ye
QY
Department of SICU, the first Affiliated Hospital of Sun Yat-sen University, Guangzhou 520080, China. kouqiuye@hotmail.com
Chen
Juan
J
Ouyang
Bin
B
Guan
Xiang-dong
XD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016207:Cytokines / Q000097:blood*; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000628:therapy*; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha