Continuous arteriovenous hemofiltration therapy for Staphylococcus aureus-induced septicemia in immature swine.

Abstract

OBJECTIVES:

The goals of this study were: a) to evaluate the efficacy of controlled, continuous arteriovenous hemofiltration in improving morbidity and mortality rates in an immature swine model of Staphylococcus aureus-induced septicemia; b) to determine if ultrafiltrate from septic animals contained mediators that produce pathophysiologic changes observed in untreated S. aureus septic pigs.

DESIGN:

Prospective, randomized, controlled study with age-matched controls.

SETTING:

U.S. Department of Agriculture-licensed biomedical research facility.

SUBJECTS:

Sixty-five weaned Poland-China swine (4 to 6 wks of age; 5 to 10 kg).

INTERVENTIONS:

Part 1: Animals received a lethal dose of live S. aureus (8 x 10(9) colony-forming units/kg) over 1 hr. The three treatment groups included: hemofiltration group 1 (eight filtered, eight nonfiltered animals), plasma filtration fraction = 5.5%; hemofiltration group 2 (six filtered, six nonfiltered animals), filtration fraction = 16.6%; and hemofiltration group 3 (six filtered, six nonfiltered animals), filtration fraction = 33.4%. A control, nonseptic group of animals (n = 4) was filtered to obtain "clean" ultrafiltrate (hemofiltration group 4). Part 2: Sterile ultrafiltrate concentrate batches obtained from each group of filtered, septic animals were concentrated and infused into healthy, nonseptic pigs (reinfusion groups 1 through 3).

MEASUREMENTS AND MAIN RESULTS:

Physiologic, biochemical, and hematologic variables were measured in all animals every 1 to 3 hrs. Overall length of survival was also recorded. In hemofiltration groups 1 through 3, filtered animals survived significantly longer than matched, nonfiltered (sham-filtered) animals. Increments in survival time increased directly with filtration fraction. Ultrafiltrate concentrate from septic pigs produced death (LD41) and disease similar to those rates observed in untreated S. aureus-septic pigs. Infusion of clean ultrafiltrate concentrate produced no response.

CONCLUSIONS:

Continuous arteriovenous hemofiltration significantly improved survival rates in swine with S. aureus-induced sepsis. Resultant ultrafiltrate concentrate contained mediators responsible for some pathophysiologic responses observed in this animal model.

• Authors: P A Lee, J R Matson, R W Pryor, L B Hinshaw
• Journal: Critical care medicine (Crit Care Med) Vol. 21 Issue 6 Pg. 914-24 (Jun 1993) ISSN: 0090-3493 [Print] United States
• PMID: 8504662 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose

Topics

• Age Factors
• Animals
• Bacteremia (blood, mortality, physiopathology, therapy)
• Biological Assay
• Blood Gas Analysis
• Blood Glucose (analysis)
• Disease Models, Animal
• Female
• Hemodynamics
• Hemofiltration (instrumentation, methods)
• Lethal Dose 50
• Male
• Platelet Count
• Random Allocation
• Staphylococcal Infections (blood, mortality, physiopathology, therapy)
• Survival Rate
• Swine