Document Detail


Continuous Renal Replacement Therapy to Reduce Inflammation in a Piglet Hemorrhage-Reperfusion Extra-corporeal Membrane Oxygenation Model.
MedLine Citation:
PMID:  22669297     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:During extracorporeal membrane oxygenation (ECMO), circulation of blood across synthetic surfaces triggers an inflammatory response. Thus, we evaluated the ability of continuous renal replacement therapy (CRRT) to remove cytokines and reduce the inflammatory response in a piglet hemorrhage-reperfusion ECMO model.Methods:Three groups were studied: 1) uninjured controls (n=11); 2) hemorrhage-reperfusion while on veno-arterial (VA) ECMO (30% hemorrhage with subsequent blood volume replacement within 60 minutes) (n=8); 3) treatment with CRRT after hemorrhage-reperfusion while on ECMO (n= 7). Hemodynamic parameters, oxygen utilization, and plasma and broncho-alveolar lavage (BAL) cytokine levels were recorded and lung tissue samples collected for histologic comparison.Results:Whereas mean arterial pressures (MAP) decreased among hemorrhage-reperfusion piglets, ECMO with CRRT did not significantly alter MAP nor systemic vascular resistance and was able to maintain blood flow as well as oxygen delivery after hemorrhage-reperfusion. Plasma inter-leukin (IL)-6 and IL-10, and BAL tumor necrosis factor (TNF)-α, IL-1β, IL-6, IL-8, and IL-10 increased as a result of hemorrhage-reperfusion while on ECMO. After a six hour period of CRRT, plasma IL-6 and BAL TNF-α,IL-6, and IL-8 levels decreased.Conclusion:Data suggest CRRT may decrease inflammatory cytokine levels during the initial phase of ECMO therapy following hemorrhage-reperfusion while maintaining cardiac output and oxygen utilization.
Authors:
Thornton S Mu; Eldon G Palmer; Sherreen G Batts; Sarah L Lentz-Kapua; Jane H Uyehara-Lock; Catherine F T Uyehara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-05
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatrics, Tripler Army Medical Center, 1 Jarrett White Rd., Honolulu, HI 96859.
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