Top

Published in:

01-11-2003 | Experimental

Effect of continuous hemofiltration on hemodynamics, lung inflammation and pulmonary edema in a canine model of acute lung injury

Authors: Xiao Su, Chunxue Bai, Qunying Hong, Duming Zhu, Lixian He, Jianping Wu, Feng Ding, Xiaohui Fang, Michael A. Matthay

Published in: Intensive Care Medicine | Issue 11/2003

Abstract

Objective

This study examined whether continuous hemofiltration favorably affects cardiopulmonary variables, lung inflammation, and lung fluid balance in a canine model of oleic acid induced acute lung injury.

Methods

Eleven pentobarbital-anesthetized dogs were randomly divided into a control (mechanical ventilation, MV) group (n=6) and a MV plus hemofiltration (HF) group (n=5). All animals received an intravenous injection of oleic acid (0.09 ml/kg) to induce acute lung injury. Continuous arterial-venous hemofiltration (blood flow 100 ml/min, ultrafiltration rate at 50–65 ml kg⁻¹ h⁻¹) was started after establishment of oleic acid induced acute lung injury and continued for 4 h. Hemodynamics, lung mechanics, gas exchange, lung fluid balance, lung histology, and the level of plasma cytokines were assessed.

Results

After 240 min of HF treatment there was a significant increase in cardiac output, reduction in pulmonary arterial pressure, and improvement in both oxygenation and lung mechanics. Also, in the HF group the lung wet-to-dry weight ratio was significantly reduced. Histologically, HF reduced edema and inflammatory cell infiltration in the lung. There was also a significantly greater decrease in plasma IL-6 and IL-8 levels in the HF group than in group receiving MV alone.

Conclusions

In a canine model of acute lung injury continuous HF improved cardiopulmonary function, reduced pulmonary edema, decreased lung permeability and inflammation, and decreased the plasma concentration of proinflammatory cytokines.

Ware LB, Matthay MA (2000) The acute respiratory distress syndrome. N Engl J Med 342:1334–1349PubMed

Matthay MA, Zimmerman GA, Esmon C, Bhattacharya J, Coller B, Doerschuk CM, Floros J, Gimbrone MA Jr, Hoffman E, Hubmayr RD, Leppert M, Matalon S, Munford R, Parsons P, Slutsky AS, Tracey KJ, Ward P, Gail DB, Harabin AL (2003) Future research directions in acute lung injury: summary of a national heart, lung, and blood institute working group. Am J Respir Crit Care Med 167:1027–1035CrossRefPubMed

Bauer M, Marzi I, Ziegenfuss T, Riegel W (2001) Prophylactic hemofiltration in severely traumatized patients: effects on post-traumatic organ dysfunction syndrome. Intensive Care Med 27:376–383

Bellomo R, Tipping P, Boyce N (1995) Interleukin-6 and Interleukin-8 extraction during continuous venovenous hemofiltration in septic acute renal failure. Ren Fail 17:457–466PubMed

Boga M, Islamoglu Badak I, Cikirikcioglu M, Bakalim T, Yagdi T, Buket S, Hamulu A (2000) The effects of modified hemofiltration on inflammatory mediators and cardiac performance in coronary artery bypass grafting. Perfusion 15:143–150PubMed

Cole L, Bellomo R, Journois D, Davenport P, Baldwin I, Tipping P (2001) High-volume haemofiltration in human septic shock. Intensive Care Med 27:978–986PubMed

De Vriese AS, Colardyn FA, Philippe JJ, Vanholder RC, De Sutter JH, Lameire NH (1999) Cytokine removal during continuous hemofiltration in septic patients. J Am Soc Nephrol 10:846–853PubMed

De Vriese AS, Vanholder RC, Pascual M, Lameire NH, Colardyn. FA (1999) Can inflammatory cytokines be removed efficiently by continuous renal replacement therapies? Intensive Care Med 25:903–910PubMed

Mink SN, Li X, Bose D, Gu M, Liu G, Jacobs H, Light RB (1999) Early but not delayed continuous arteriovenous hemofiltration improves cardiovascular function in sepsis in dogs. Intensive Care Med 25:733–743CrossRefPubMed

10.

Rogiers P, Zhang H, Smail N, Pauwels D, Vincent JL (1999) Continuous venovenous hemofiltration improves cardiac performance by mechanisms other than tumor necrosis-α attenuations during endotoxic shock. Crit Care Med 27:1848–1855PubMed

11.

Stein B, Pfenniger E, Grunert A, Schmitz JE, Hudde M (1990) Influence of continuous hemofiltration on hemodynamics and central blood volume in experimental endotoxic shock. Intensive Care Med 16:494–499PubMed

12.

Stein B, Pfenniger E, Grunert A, Schmitz AJE, Deller A, Kocher F (1991) The consequences of continuous hemofiltration on lung mechanics and extravascular lung water in a porcine endotoxic shock model. Intensive Care Med 17:293–298PubMed

13.

Syrbu S, Thrall RS, Smilowitz HM (1996) Sequential appearance of inflammatory mediators in rat bronchoalveolar lavage fluid after oleic acid-induced lung injury. Exp Lung Res 22:33–49PubMed

14.

Furue S, Kuwabara K, Mikawa K, Nishina K, Shiga M, Maekawa N, Ueno M, Chikazawa Y, Ono T, Hori Y, Matsukawa A, Yoshinaga M, Obara H (1999) Crucial role of group IIA phospholipase A (2) in oleic acid-induced acute lung injury in rabbits. Am J Respir Crit Care Med 160:1292–1302PubMed

15.

Kuwabara K, Furue S, Tomita Y, Ueno M, Ono T, Matsukawa A, Yoshinaga M, Mikawa K, Nishina K, Shiga M, Obara H, Hori Y (2001) Effect of methylprednisolone on phospholipase A (2) activity and lung surfactant degradation in acute lung injury in rabbits. Eur J Pharmacol 433:209–216CrossRefPubMed

16.

Mitaka C, Hirata Y, Habuka K, Narumi Y, Yokoyama K, Makita K, Imai T (2002) Atrial natriuretic peptide improves pulmonary gas exchange by reducing extravascular lung water in canine model with oleic acid-induced pulmonary edema. Crit Care Med 30:1570–1575PubMed

17.

Neumann P, Berglund JE, Andersson LG, Maripu E, Magnusson A, Hedenstierna G (2000) Effects of inverse ratio ventilation and positive end-expiratory pressure in oleic acid-induced lung injury. Am J Respir Crit Care Med 161:1537–1545PubMed

18.

Abraham E, Matthay MA, Dinarello CA, Vincent JL, Cohen J, Opal SM, Glauser M, Parsons P, Fisher CJ Jr, Repine JE (2000) Consensus conference definitions for sepsis, septic shock, acute lung injury, and acute respiratory distress syndrome: time for a reevaluation. Crit Care Med 28:232–235

19.

Zor T, Selinger Z (1996) Linearization of the Bradford protein assay increases its sensitivity: theoretical and experimental studies. Anal Biochem 236:302–308CrossRefPubMed

20.

Rennard SI, Basset G, Lecossier D, O’Donnell KM, Pinkston P, Martin PG, Crystal RG (1986) Estimation of volume of epithelial lining fluid recovered by lavage using urea as marker of dilution. J Appl Physiol 60:532–538

21.

Jeng MJ, Kou YR, Sheu CC, Hwang B (2002) Effects of partial liquid ventilation with FC-77 on acute lung injury in newborn piglets. Pediatr Pulmonol 33:12–21CrossRefPubMed

22.

Rosenthal C, Caronia C, Quinn C, Lugo N, Sagy M (1998) A comparison among animal models of acute lung injury. Crit Care Med 26:912–916PubMed

23.

Gomez A, Wang R, Unruh H, Light RB, Bose D, Chau T, Correa E, Mink S (1990) hemofiltration reverses left ventricular dysfunction during sepsis in dogs. Anesthesiology 73:671–685PubMed

24.

Honore PM, Jamez J, Wauthier M, Lee PA, Dugernier T, Pirenne B, Hanique G, Matson JR (2000) Prospective evaluation of short-term, high-volume isovolemic hemofiltration on the hemodynamic course and outcome in patients with intractable circulatory failure resulting from septic shock. Crit Care Med 28:3581–3587

25.

Reeves JH, Butt WW, Shann F (1999) Continuous plasmafiltration in sepsis syndrome. Plasmafiltration in Sepsis Study Group. Crit Care Med 27:2096–2104

26.

27.

Grotendorst AF, van Bommel EFH, Van der Hoven B, van Osta ALM (1992) High volume hemofiltration improves right ventricular function in endotoxin-induced shock in the pig. Intensive Care Med 18:235–240PubMed

28.

Rivera ES, Kimball TR, Bailey WW, Witt SA, Khoury PR, Daniels SR (1998) Effect of veno-venous ultrafiltration on myocardial performance immediately after cardiac surgery in children. A prospective randomized study. J Am Coll Cardiol 32:766–772CrossRefPubMed

29.

Miller EJ, Cohen AB, Nagao S, Griffith D, Maunder RJ, Martin TR, Weiner-Kronish JP, Sticherling M, Christophers E, Matthay MA (1992) Elevated levels of NAP-1/interleukin-8 are present in the airspaces of patients with the adult respiratory distress syndrome and are associated with increased mortality. Am Rev Respir Dis 146:427–432PubMed

30.

Tyburski JG, Dente C, Wilson RF, Steffes C, Devlin J, Carlin AM, Flynn LM, Shanti C (2001) Differences in arterial and mixed venous IL-6 levels: the lungs as a source of cytokine storm in sepsis. Surgery 130:748–751CrossRefPubMed

31.

32.

Kellum JA, Dishart MK (2002) Effect of hemofiltration filter adsorption on circulating IL-6 levels in septic rats. Crit Care 6:429–433CrossRefPubMed

33.

Cole L, Bellomo R, Journois D, Davenport P, Baldwin I, Tipping P (2001) High-volume haemofiltration in human septic shock. Intensive Care Med 27:978–986PubMed

34.

Ullrich R, Roeder G, Lorber C, Quezado ZM, Kneifel W, Gasser H, Schlag G, Redl, Germann P (2001) Continuous venovenous hemofiltration improves arterial oxygenation in endotoxin-induced lung injury in pigs. Anesthesiology 195:428–436

35.

Bauer M, Marzi I, Ziegenfuss T, Riegel W (2001) Prophylactic hemofiltration in severely traumatized patients: effects on post-traumatic organ dysfunction syndrome. Intensive Care Med 27:376–383

36.

Bellomo R, Tipping P, Boyce N (1995) Interleukin-6 and Interleukin-8 extraction during continuous venovenous hemofiltration in septic acute renal failure. Ren Fail 17:457–466PubMed

37.

Oda S, Hirasawa H, Shiga H, Nakanishi K, Matsuda K, Nakamura M (2002) Continuous hemofiltration/hemodiafiltration in critical care. Ther Apher 6:193–198CrossRefPubMed

38.

Wakabayashi Y, Kamijou Y, Soma K, Ohwada T (1996) Removal of circulating cytokines by continuous hemofiltration in patients with systemic inflammatory response or multiple organ dysfunction syndrome. Br J Surg 83:393–394PubMed

39.

Journois D, Israel-Biet D, Pouard P, Rolland B, Silvester W, Vouhe P, Safran D (1996) High-volume, zero-balanced hemofiltration to reduce delayed inflammatory response to cardiopulmonary bypass in children. Anesthesiology 85:965–976PubMed

Title: Effect of continuous hemofiltration on hemodynamics, lung inflammation and pulmonary edema in a canine model of acute lung injury
Authors: Xiao Su
Chunxue Bai
Qunying Hong
Duming Zhu
Lixian He
Jianping Wu
Feng Ding
Xiaohui Fang
Michael A. Matthay
Publication date: 01-11-2003
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 11/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-2017-3

At a glance: The STEP trials

Springer Medicine

Effect of continuous hemofiltration on hemodynamics, lung inflammation and pulmonary edema in a canine model of acute lung injury

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2003

Pharmacokinetics of long-term sufentanil infusion for sedation in ICU patients

Early antibiotic treatment (prophylaxis) of septic complications in severe acute necrotizing pancreatitis: a prospective, randomized, multicenter study comparing two regimens with imipenem-cilastatin

Helicobacter pylori in intensive care: why we should be interested

Gastric PgCO2 and Pg-aCO2 gap are related to d-lactate and not to l-lactate levels in patients with septic shock

Acute community-acquired bacterial meningitis in adults admitted to the intensive care unit: clinical manifestations, management and prognostic factors

Noninvasive continuous positive airway pressure ventilation using a new helmet interface: a case-control prospective pilot study