Cardiac contractility during hemofiltration in an awake model of hyperdynamic endotoxemia.
BACKGROUND
To determine whether continuous veno-venous hemofiltration can ameliorate hemodynamic instability and left ventricular (LV) dysfunction by reducing circulating plasma mediators, the authors used the LV end-systolic elastance (Ees) as a contractility index, in an awake swine model simulating human hyperdynamic endotoxemia.


METHODS
Nineteen instrumented pigs were divided into a control group (CTRL, n = 7), a hemofiltration (HF, n = 7) group, and an extracorporeal circuit (ECC, n = 5) only group. All animals received intravenous E. coli endotoxin (10 microg x kg x h) and resuscitation in a common regimen for 24 hours. Hemofiltration was started 30 minutes after initiation of endotoxemia and continued until the end of the experiment.


RESULTS
: Ees was maintained at baseline levels in the HF group, whereas a progressive decrease of Ees was found in both the CTRL and the ECC groups. Cardiac output was significantly higher in the HF group than the CTRL group. There was no significant difference between the groups in plasma catecholamines.


CONCLUSIONS
We conclude that hemofiltration prevented LV impairment.
Ishihara
Satoshi
S
Department of Acute Medicine (S.I.), Kawasaki Medical School, Okayama, Japan. ishihara@med.kawasaki-m.ac.jp
Ward
John A
JA
Tasaki
Osamu
O
Pruitt
Basil A
BA
Mozingo
David W
DW
D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output; D003243:Consciousness; D004195:Disease Models, Animal; D019446:Endotoxemia / Q000382:microbiology / Q000503:physiopathology*; D004927:Escherichia coli Infections / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics; D006440:Hemofiltration / Q000379:methods; D009200:Myocardial Contraction / Q000502:physiology*; D013552:Swine; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000517:prevention & control; D016277:Ventricular Function, Left / Q000502:physiology; D017725:Ventricular Pressure