Skip to main content
Log in

Influence of continuous haemofiltration on haemodynamics and central blood volume in experimental endotoxic shock

  • Originals
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

In order to asses the influence of continuous haemofiltration (HF) on haemodynamics and central blood volume in endotoxic shock, endotoxinaemia was invoked in 20 swine (28–32 kg). 15 min after doubling the mean pulmonary pressure, the animals were randomly assigned to receive either a zero-balanced veno-venous HF with an ultrafiltration and replacement rate of 600 ml/h (HF group,n=10) or to observe the spontaneous course (E group,n=10) under a constant infusion of endotoxin for 4h. A trend to a higher survival rate in the HF group (6/10 vs. 3/10; group) during the observation period was evident, but not statistically significant. Early initiation of HF during endotoxic shock modifies the haemodynamic response, lowering the pulmonary artery pressure (PAP), PCWP, pulmonary (PVR) and systemic vascular resistance (SVR), compared to the spontaneous course, whereas the decrement of central blood volume was comparable in both groups. These changes cannot be explained by effects of the HF on the volume status, but supports and additional effect by the filtration of small and medium-sized molecules.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mauritz W, Sporn P, Schindler I, Zadrobilek E, Roth E, Appel W (1986) Akutes Nierenversagen bei abdomineller Sepsis — Vergleich von Hämodialyse und kontinuierlicher arteriovenöser Hämofiltration. Anästh Intensivther Notfallmed 21:212–217

    Google Scholar 

  2. Simpson K, Allison M (1988) Acute renal failure — continuous ultrafiltration and bicarbonate haemodialysis (CUPID). Intensive Care World 5:83–84

    Google Scholar 

  3. Schetz M, Lauwers PM, Ferdinande P (1989) Extracorporeal treatment of acute renal failure in the intensive care unit: a critical view. Intensive Care Med 15:349–357

    Google Scholar 

  4. Wendon J, Smithies M, Sheppard M, Bullen K, Tinker J, Bihari D (1989) Continuous high volume venous-venous haemofiltration in acute renal failure. Intensive Care Med 15:358–363

    Google Scholar 

  5. Gotloib L, Barzilay E, Shustak A, Wais Z, Jaichenko J, Lev A (1986) Hemofiltration in septic ARDS. The artifical kidney as an artificial endocrine lung. Resuscitation 13:123–132

    Google Scholar 

  6. Staubach KH, Rau HG, Kooistra A, Schardey HM, Hohlbach G, Schildberg FW (1988) Can Hemofiltration increase survival time in acute endotoxinemia — a porcine shock model. Abstract: 2nd Vienna Shock, Forum, May 11–14, 1988, Vienna, Austria, p 69

  7. Borg T, Alvfors A, Gerdin B, Modig J (1985) A porcine model of early adult respiratory distress syndrome induced by endotoxinaemia. Acta Anaesthesiol Scand 29:814–830

    Google Scholar 

  8. Kreimeier U, Gerspach S, Veitinger K, Neuhof H, Meßmer K (1988) Hyperdyname Endotoxinämie — Mikrozirkulationsstörung und Eicosanoide. In: Schriefers KH (ed) Chirurgisches Forum 88 für experimentelle und klinische Forschung. Springer, Berlin Heidelberg New York, pp 291–295

    Google Scholar 

  9. Lava JS, Rice CL, Levine HA, Moss GS (1982) Extravascular lung water as a function of the magnitude of pulmonary artery pressure in the septic pig. J Surg Res 32:440–447

    Google Scholar 

  10. Modig J (1987) Positive effects of Ketamine versus Metomidate anesthesia on cardiovascular function, oxygen delivery and survival. Acta Chir Scand 153:7–13

    Google Scholar 

  11. Modig J (1988) Comparison of effects of dextran-70 and Ringers acetate on pulmonary function, hemodynamics and survival in experimental septic shock. Crit Care Med 16:266–271

    Google Scholar 

  12. Ball HA, Cook JA, Wise WC, Halushka PV (1986) Role of thromboxane, prostaglandins and leukotrienes in endotoxic and septic shock. Intensive Care Med 12:116–126

    Google Scholar 

  13. Pfeiffer UJ (1987) Das intrathorakale Blutvolumen als Leitparameter zur Blutvolumenregulation in der Intensivmedizin. Habilitationsschrift, Technische Universität München, 1987

  14. Stein B, Maucher H, Wiedeck H, Born B, Ahnefeld FW (1989) Die Steuerung der Ultrafiltrationsrate als Hauptkomponente eines neuen Bilanzierungssystems während kontinuierlicher Hämofiltration. Anaesthesist 38:536–538

    Google Scholar 

  15. Wardle N (1982) Acute Renal Failure in the 1980's: the Importance of Septic Shock and of Endotoxinaemia. Nephron 30:193–200

    Google Scholar 

  16. Houtchens BA, Westenkow DR (1984) Oxygen consumption in septic shock. Circ Shock 13:361–384

    Google Scholar 

  17. Groeneveld ABJ, Nauta JJP, Thijs LG (1988) Peripheral vascular resistance in septic shock: its relation to outcome. Intensive Care Med 14:141

    Google Scholar 

  18. Bond RF (1985) Peripheral circulatory responses to endotoxin. In: Proctor RA (ed) Handbook of endotoxin, vol 2. Pathophysiology of endotoxin. Elsevier, Amsterdam New York, pp 36–75

    Google Scholar 

  19. Magilligan DJ (1985) Effects of ultrafiltration on lung water. In: Sieberth HG, Mann H (eds) Continuous arteriovenous hemofiltration (CAVH). Karger, Basel München, pp 80–95

    Google Scholar 

  20. Baldamus CA (1986) Hemodynamics in hemofiltration. In: Henderson LW, Quellhorst EA, Baldamus CA, Lysaght MJ (eds) Hemofiltration. Springer, Berlin Heidelberg New York, pp 155–200

    Google Scholar 

  21. Vagge R, Cavatora F, Queirelo C, Rosselli P, Gentile A, Bertulla A (1988) Hemodynamic changes during acetate dialysis, bicarbonate dialysis and hemofiltration. Blood Purif 6:43–50

    Google Scholar 

  22. Coraim F, Pauser G, Stellwag F, Werner T, Ziegler W (1985) Positive Beeinflussung der Hämodynamik bei postkardiochirurgischen Patienten durch die Hämofiltration. Anaesthesist 34:236

    Google Scholar 

  23. McManus LM, Hanahan DJ, Demopoulos CA, Pinckard RN (1980) Pathobiology of the intravenous infusion of acetyl glyceryl ether phosphorylcholine (AGEPC), a synthetic platelet-activating factor (PAF), in the rabbit. J Immunol 124:2919–2921

    Google Scholar 

  24. Beutler B, Cerami A (1987) Cachectin: more than a tumor necrosis factor. N Engl J Med 316:379–385

    Google Scholar 

  25. Parillo JE, Burch C, Shelhamer JH, Parker MM, Natanson C, Schuette W (1985) A circulating myocardial depressant substance in humans with septic shock. J Clin Invest 76:1539–1553

    Google Scholar 

  26. Kühl PG, Bolds JM, Loyd J, Snapper JR, Fitzgerald GA (1988) Thromboxane receptor-mediated bronchial and haemodynamic responses in ovine endotoxinemia. Am J Physiol 254:R310–319

    Google Scholar 

  27. Parillo JE (1985) Cardiovascular dysfunction in septic shock: new insights into a deadly disease. Int J Cardiol 7:314–316

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stein, B., Pfenninger, E., Grünert, A. et al. Influence of continuous haemofiltration on haemodynamics and central blood volume in experimental endotoxic shock. Intensive Care Med 16, 494–499 (1990). https://doi.org/10.1007/BF01709399

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01709399

Key words

Navigation