In-line hemofiltration minimized extracorporeal membrane oxygenation-related inflammation in a porcine model.
We evaluated a pattern for connecting a hemofiltration apparatus after the ECMO oxygenator and observed the effects on the levels of inflammatory cytokines. All animals were anesthetized and ventilated, were randomly divided into 3 groups and observed for 24 h: S group (n = 6) received cannulation and heparin infusion; E group (n = 6) received venovenous (VV)-ECMO and heparin infusion; E+H group (n = 6) received hemofiltration with VV-ECMO placed after the oxygenator and heparin infusion. Hemodynamics, gas exchange parameters and plasma cytokine levels were measured simultaneously. After VV-ECMO, oxygenation was maintained in the E and E+H groups. In the E group, the levels of TNF-α, IL-1β, IL-6 and IL-8 increased markedly in the first 2-6 h and then remained stable from 12-24 h. Concentrations of TNF-α, IL-1β, IL-6 and IL-8 in the E+H group were lower than those in the E group. We concluded that the manner of connecting the hemofiltration apparatus after the oxygenator helped maintain adequate oxygenation and was easy to perform. Connecting hemofiltration to ECMO minimized the ECMO-associated effects of pro-inflammatory cytokines.
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Jialiang
J
S
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Juanhong
J
S
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Qiyi
Q
C
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China yudrnj@163.com.
Wenkui
W
Yu
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Changsheng
C
H
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Yimin
Y
H
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Juanjuan
J
Z
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Tao
T
G
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Fengchan
F
X
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University Nanjing, Jiangsu Province, China.
Jieshou
J
L
D000818:Animals; D016207:Cytokines / Q000097:blood*; D004195:Disease Models, Animal; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D017583:Hemodiafiltration / Q000379:methods*; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D008297:Male; D013552:Swine; D013997:Time Factors
D016207:Cytokines
C-reactive protein; cytokines; extracorporeal membrane oxygenation; hemofiltration; systemic inflammatory response