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

• Published in: Intensive care medicine Vol. 29; no. 11; pp. 2034 - 2042
• Main Authors: XIAO SU, CHUNXUE BAI, QUNYING HONG, DUMING ZHU, LIXIAN HE, JIANPING WU, FENG DING, XIAOHUI FANG, MATTHAY, Michael A
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.11.2003; Berlin Springer Nature B.V
• Subjects: Acids; Albumins - analysis; Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Biopsy; Blood Gas Analysis; Bronchoalveolar Lavage Fluid - chemistry; Catheters; Cytokines; Cytokines - blood; Disease Models, Animal; Dogs; Edema; Emergency and intensive care: renal failure. Dialysis management; Female; Gases; Hemodynamics; Hemofiltration - instrumentation; Hemofiltration - methods; Histology; Inflammation; Intensive care medicine; Male; Mechanics; Medical sciences; Oleic Acid; Plasma; Pulmonary arteries; Pulmonary Edema - chemically induced; Pulmonary Edema - diagnosis; Pulmonary Edema - physiopathology; Pulmonary Edema - therapy; Pulmonary Gas Exchange; Random Allocation; Respiration, Artificial; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - chemically induced; Respiratory Distress Syndrome, Adult - diagnosis; Respiratory Distress Syndrome, Adult - physiopathology; Respiratory Distress Syndrome, Adult - therapy; Respiratory Mechanics; Severity of Illness Index; Single-Blind Method; Tropical medicine; Veins & arteries; Ventilators; United States > US; Intensive care; Continuous; Artificial ventilation; Interleukin 6; Extrarenal dialysis; Oleic acid; Hemofiltration; Mechanic of breathing; Dog; Interleukin 8; Fissipedia; Lung disease; Acute lung injury; Carnivora; Respiratory disease; Cytokine; Inflammation; Lung edema; Vertebrata; Mammalia; Treatment; Adult respiratory distress syndrome; Animal; Lung mechanics; Hemodynamics; Mechanical ventilation
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-003-2017-3

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. 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. 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. 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.