RESUMO
ObjectiveTo explore the role of high volume hemofiltration (HVHF) in preventing and treating multipleorgandysfunctionsyndrome(MODS)by observingthealterationsof plasma lipopolysaccharide (LPS) and its receptor CD14.Methods Twelve Beagle dogs were subjected to hemorrhagic shock and injection of LPS to set up MODS model, and then dogs with MODS were randomly (random number) divided into two groups: HVHF group (n =6) and MODS group (n =6). HVHF was performed about 24 hours after LPS injection in MODS dogs of HVHF group. LPS, CD14 and organ function variables were determined before operation (T1 ), before LPS injection (T2 ) and 0 h (T3) , 3 h (T4 ), 6 h ( T5 ), 9h (T6 ), 12 h (T7), 15 h ( Ts ) and 24 h (T9) after LPS injected. The levels of LPS were determined by using rapid microbiological kinetic reader (MB-80). CD14 was measured by using ELISA. Differences in LPS, CD14 and organ function at different intervals were evaluated by analysis of variance for repeated measures. ResultsCompared with the MODS group, plasma levels of LPS and CD14 were significantly decreased in the HVHF group at T4-9 ( P ＜ 0. 01 ). CD~ were detected in the ultrafiltrate, the sieving coefficients (SC) for CD14 were 0. 81 ±0. 09. LPS could not be detected in the ultrafiltrate. The beneficial effect of HVHF on the hypotension in MODS model was particularly striking at T4-9 (P ＜ 0. 01 ). Mean arterial oxygen tension in HVHF groups at T4-9 was significantly higher than that in MODS group (P ＜0. 01 ).The levels of creatinine and urea nitrogen were decreased significantly in the HVHF group compared with the MODS group at T4-9 ( P ＜ 0. 01 ) Conclusions HVHF restrained excessive inflammatory responses by cutting down the peak value of plasma LPS and CD14, improving the functions of major organs in MODS dogs.
