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

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.

• Authors: Xiao Su, Chunxue Bai, Qunying Hong, Duming Zhu, Lixian He, Jianping Wu, Feng Ding, Xiaohui Fang, Michael A Matthay
• Journal: Intensive care medicine (Intensive Care Med) Vol. 29 Issue 11 Pg. 2034-42 (Nov 2003) ISSN: 0342-4642 [Print] United States
• PMID: 14557856 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Albumins
• Cytokines
• Oleic Acid

Topics

• Albumins (analysis)
• Analysis of Variance
• Animals
• Biopsy
• Blood Gas Analysis
• Bronchoalveolar Lavage Fluid (chemistry)
• Cytokines (blood)
• Disease Models, Animal
• Dogs
• Female
• Hemodynamics
• Hemofiltration (instrumentation, methods)
• Male
• Oleic Acid
• Pulmonary Edema (chemically induced, diagnosis, physiopathology, therapy)
• Pulmonary Gas Exchange
• Random Allocation
• Respiration, Artificial
• Respiratory Distress Syndrome (chemically induced, diagnosis, physiopathology, therapy)
• Respiratory Mechanics
• Severity of Illness Index
• Single-Blind Method