Effects of continuous veno-venous hemofiltration on hemodynamics and proinflammatory cytokines during endotoxic shock in sheep / 中华麻醉学杂志

ABSTRACT

Objective The effectiveness of continuous veno-venous hemofiltration (CVVH) in clearing cytokines and reducing mortality in endotoxic shock is still controversial. The purpose of this study was to investigate the effects of CVVH on hemodynamies and plasma proinflammatory cytokines (TNF-?, IL-6, IL-10) during endotoxic shock in sheep. Methods Twelve male sheep weighing 14.5-20.5 kg were randomly divided into two groups of six animals(A) control group and (B) CVVH group. Endotoxin (L-2880 sigma) 1 mg?kg-1 was infused intravenously(i.v. ) over 30 min and lactated Ringer's solution at 15 mlf44kg-1 f44h-1 for 6h in both groups. In CVVH group (B) CVVH was used for 5 h starting from 1h after the beginning of endotoxin infusion. The animals were anesthetized with midazolam and vecuronium. After tracheal intubation the animals were mechanically ventilated. Femoral artery was cannulated for continuous direct BP monitoring. 5F Swan-Ganz catheter was inserted into pulmonary artery via right internal jugular vein. Cardiac output ( CO), stroke volume ( SV), cardiac index (CI), MPAP, PAWP, SVRI, PVRI and LVSWI were measured, calculated and recorded before endotoxin infusion (T0 , baseline) and at 30, 60, 90, 120, 210 and 360 min (T6) after endotoxin infusion was started. Blood and ultrafiltrate samples were taken at T6 for determination of TNF-a,IL-6 and IL-10 concentrations. Results MAP and SVRI were significantly decreased while HR and SVRI were significantly increased after T, in both groups. MAP and SVRI were significantly higher at T6 in CVVH group than in control group ( P