Organ Protection Of Early High Volume Hemofiltration In A Septic Shock Swine Model

Objective:The aim of this study was to investigate the possible molecular and pathophysiological mechanisms of early fluid resuscitation combined HVHF in preventing and treating multiple organ dysfunctionsExperimental Animals:18healthy swine (weighed23-25kg).Experimental Methods:18pigs were divided randomly into three groups.Diluted Escherichia coli lipopolysaccharide (LPS) was continuously and intravenously infused at the rate of50μg·kg-1·h-1to induce septic shock model. Then fluid resuscitation was given and vasoactive drugs were used to maintain blood pressure during tissue perfusion. The control group was only treated with extracorporeal blood circulation, and the other two groups were treated with continuous venovenous hemofiltration (CVVH) and high volume hemofiltration (HVHF) at the rate of25ml·kg-1·h-1and85ml·kg-1·h-1, respectively. control group, CRRT group, HVHF group and hemodynamic parameters, PIC CO monitoring indicators and vasoactive drugs and maintain time were monitored, plusma concentrations of IL-6and IL-10were measured, NF-Kappa B mRNA of major organs were detected, and the stuffed animals were sacrificed for histopathology.Results:Early high-volume hemofiltration can significantly reduce the level of expression of NF-kappa B in tissues and organs, reduce plasma cytokine levels, reduce the amount of vasoactive drugs and maintenance time, and to mitigate the damage of tissues and organs.Conclusion:NF-kappa B activation and excessive inflammation might play a very important role in the development of MODS. HVHF can inhibit the activation of NF-kappa B through a number of ways, thereby regulate transcription of IL-6, IL-10and other inflammatory cytokines, and thus play a role to protect organ function.