Efficacy of continuous arteriovenous hemofiltration in endotoxic shock

S. M. Heidemann, J. P. Ofenstein, A. P. Sarnaik

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23 Scopus citations

Abstract

We determined the efficacy of continuous arteriovenous hemofiltration (CAVH) in removing tumor necrosis factor (TNF), thromboxane A2, and prostacyclin, and in improving survival in endotoxemia. Twelve rats were given 10 mg/kg of E. coli 0:127:B8 lipopolysaccharide. Fifteen min later, the rats were randomized to ultrafiltered or non-ultrafiltered groups. Blood and ultrafiltrate were collected for TNF, thromboxane B2 (TxB2), and 6-keto- prostaglandin F1α (6-keto-PGF1α). After 4 hr, surviving rats were sacrificed. Five of 6 ultrafiltered and none of 6 non-ultrafiltered rats survived 4 hr. Plasma TxB2 >1,000 pcg/ml and its rate of increase within the first 2 hr predicted death (P < 0.03). Ultrafiltration decreased the rate of rise in TxB2 (P < 0.04). Plasma TxB2 inversely correlated with TxB2 clearance by ultrafiltration. The concentration and rate of increase in TNF and 6- keto-PGF1α did not predict survival. We conclude that CAVH improves short term survival in endotoxemia. Salutary effects appear to be due to thromboxane A2 removal.

Original languageEnglish
Pages (from-to)183-187
Number of pages5
JournalCirculatory Shock
Volume44
Issue number4
StatePublished - 1994

Keywords

  • bacterial infection
  • critical illness
  • endotoxin
  • lipopolysaccharide
  • prostacyclin
  • septic shock
  • thromboxane A2
  • thromboxane B2
  • tumor necrosis factor
  • ultrafiltration

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