| Effect of continuous veno-venous hemodiafiltration on endotoxin-induced acute lung injury of the piglets. | |
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MedLine Citation:
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PMID: 20453706 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: : To evaluate the effect of continuous veno-venous hemodialysis filtration (CVVHDF) on cardiopulmonary function and clearance of inflammatory mediators in piglets with endotoxin-induced acute lung injury. DESIGN: : A randomized controlled trial. SETTING: : An animal laboratory in a tertiary care pediatric center. SUBJECTS: : Eighteen piglets, weighing 6-8 kg. INTERVENTIONS: : The piglets were anesthetized, ventilated, and received an intravenous infusion of 150 μg/kg of endotoxin. They were then randomly divided into three groups: control group (n = 6) received Ringer's lactate solution; the heparin group (n = 6) received heparin infusion plus Ringer's lactate solution; and the CVVHDF group (n = 6) received CVVHDF plus heparin infusion and Ringer's lactate solution. MEASUREMENTS AND MAIN RESULTS: : Parameters measured simultaneously were: heart rate, mean arterial blood pressure, central venous pressure, pulse contour cardiac index, cardiac function index, left ventricular contractile index, and systemic vascular resistance index; extra vascular lung water index, respiratory rate, dynamic pulmonary compliance, airway resistance, Pao2/Fio2 ratio, serum tumor necrosis factor-α, and soluble tumor necrosis factor receptor. Lung tissue was obtained for pathologic lung injury scoring and wet/dry weight ratio. Endotoxin challenge decreased oxygenation and pulmonary mechanics, suppressed cardiac function, increased extravascular lung water, and elevated serum inflammatory mediators (tumor necrosis factor-α and soluble tumor necrosis factor receptor). After CVVHDF, pulmonary function and oxygenation improved (Pao2/Fio2, 291.5 ± 75.9 vs. 217.2 ± 45.4, respectively, p < .05); arterial blood pressure and cardiac function were restored (pulse contour cardiac index, 3.95 ± 0.52 L/min/m vs. 2.69 ± 0.49 L/min/m, respectively, p < .05); extravascular lung water decreased, and serum inflammatory markers also decreased. Lung injury score improved and wet/dry weight ratio decreased. CONCLUSION: : Early CVVHDF has a beneficial effect on acute lung injury in piglets and is associated with a reduction in inflammatory cytokines, improving pulmonary function and hemodynamics and decreasing extravascular lung water and lung damage. |
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Authors:
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Guo-Ping Lu; Jing-Yu Gong; Zhu-Jin Lu; Lin-En Zhang; Niranjan Kissoon |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: 12 ISSN: 1529-7535 ISO Abbreviation: Pediatr Crit Care Med Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-06-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: e73-8 Citation Subset: IM |
Affiliation:
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From the Division of Pediatric Emergency Medicine and Critical Care Medicine (GL, ZL, LZ), Children's Hospital of Fudan University, Shanghai, P. R China; Division of Pediatric Emergency Medicine (JG), JinShan Hospital of Fudan University, Shanghai, P. R China; and the Department of Pediatrics (NK), University of British Columbia and the BC Children's Hospital, Vancouver, BC, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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