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CARDIOVASCULAR
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Volume 8, 2003, No 1-2 |
Zero-Balanced Hemofiltration during and after
Cardiopulmonary Bypass in Pigs Results in a Reduction of Plasma Cytokine Levels
with no Associated Effects on Cardiorespiratory Function
G. P. Eising, H. Schad, W. Heimisch, A. Bernhard-Abt, U. Ettner,
E. Schäffer, P. Tassani, N. Mendler, R. Lange
Background: Investigation of the effects of
hemofiltration on cardiorespiratory function, inflammatory responses and tissue
fluid accumulation after cardiopulmonary bypass (CPB) in a randomized animal
study.
Methods: 26 pigs were subjected to crystalloid primed CPB (90min
cardioplegic cardiac arrest, 30min reperfusion). Hemofiltration was performed
(n=13) during reperfusion and for 30min postCPB; filtered volume was replaced by
equal volumes of ringer’s lactate. PostCPB observation period was 5h.
Results: Following CPB, heart rate was increased, aortic pressure,
cardiac output, and dP/dtmax were reduced in both groups. Alveolar-arterial
oxygen difference was not affected in control animals, but was transiently
increased by 50% after hemofiltration. Pulmonary shunt blood flow was not
affected, pulmonary compliance was reduced by 10%-15%, pulmonary vascular
resistance was doubled in both groups without intergroup differences. Post
mortem left lung water content was 10% higher after hemofiltration compared to
controls. PostCPB elevation of plasma levels of TNF-a and IL-10 could be
prevented by hemofiltration while myocardial leukocyte infiltration was not
different between the two groups.
Conclusions: In an adult porcine model of CPB, hemofiltration with
replacement of the hemofiltrate with equal volumes of Ringer’s lactate results
in a reduction in TNF and IL-10 plasma levels with no associated effects on
heart leukocyte infiltration or immediate post CPB cardiorespiratory function.
(CVE. 2003; 8 (1/2): 87-93)
Key words: cardiopulmonary bypass, hemofiltration, organ
dysfunction, systemic inflammatory response, pigs
Gregory P. Eising, M.D.
Klinik für Herz- und Gefäßchirurgie
Deutsches Herzzentrum München
Lazarettstr. 36
D-80636 München
Germany
E-mail: eising@dhm.mhn.de
PABST SCIENCE PUBLISHERS
Lengerich, Berlin, Riga, Rom,
Wien, Zagreb