role of ultrafiltration with whole blood replacement in reducing the adverse cardiopulmonary effects of sepsis in swine model

ABSTRACT

The purpose of this study was to evaluate the effect of ultrafiltration in reducing the negative impact of sepsis on cardiovascular function, and to determine whether the replacement of the ultrafiltrate with whole blood provides beneficial mediators that may have been removed during the ultrafiltration process. Design: Despite recent advances in medicine, patients who develop serious infections frequently die. This is a result of the infections, the products they produce arid the alterations the infection causes in other organs. One postulate to help treat these infections is by "cleaning" the blood through the use of a filter. While this has been utilized in other diseases, it has not been used for patients with infections. In addition, replacing the fluid with whole blood may even be better in reversing the infection process. Setting: This study was conducted at the Duke University Medical Center, Durham, North Carolina, USA. Twenty-three swine [10-20 kg] models were randomized to one of three groups. The first group consisted of inducing sepsis without ultrafiltration to determine the spontaneous time course of the model. The second group consisted of inducing sepsis, followed by ultrafiltration and volume replacement with normal saline. The third group consisted of inducing sepsis, followed by ultrafiltration and volume replacement with whole blood. There were no noticeable improvements in any of the cardiorespiratory variables studied after ultrafiltration with either normal saline or whole blood replacement. The data obtained from this project will allow us to develop new techniques that will help patients with these serious infections