Journal
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
Volume 67, Issue 5, Pages 1055-1061Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/TA.0b013e3181a5f405
Keywords
LV function; Endotoxin; Hemofiltration; Catecholamines
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Background: To determine whether continuous veno-venous hemofiltration can ameliorate hemodynamic instability and left ventricular (LV) dysfunction by reducing circulating plasma mediators, the authors used the LV end-systolic elastance (Ees) as a contractility index, in an awake swine model simulating human hyperdynamic endotoxemia. Methods: Nineteen instrumented pigs were divided into a control group (CTRL, n = 7), a hemofiltration (HF, n = 7) group, and an extracorporeal circuit (ECC, n = 5) only group. All animals received intravenous E. coli endotoxin (10 mu g . kg(-1) . h(-1)) and resuscitation in a common regimen for 24 hours. Hemofiltration was started 30 minutes after initiation of endotoxemia and continued until the end of the experiment. Results: Ees was maintained at baseline levels in the HF group, whereas a progressive decrease of Ees was found in both the CTRL and the ECC groups. Cardiac output was significantly higher in the HF group than the CTRL group. There was no significant difference between the groups in plasma catecholamines. Conclusion: We conclude that hemofiltration prevented LV impairment.
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