EFFECTS OF CONTINUOUS VENOVENOUS HEMOFILTRATION ON CARDIOPULMONARY FUNCTION IN A PORCINE MODEL OF ENDOTOXIN-INDUCED SHOCK

Objective-To determine whether continuous venovenous hemofiltration, p roposed to remove inflammatory mediators from circulation, would resol ve cardiopulmonary derangements in a model of established endotoxic sh ock. Animals-16 clinically normal pigs. Procedure-Endotoxin was infuse d, IV, into anesthetized pigs for a total of 50 minutes. Thirty minute s after termination of the infusion period, extracorporeal circulation was initiated through a 50-kd diafilter, or past the filter without u ltrafiltrate formation. Cardiac and respiratory variables were monitor ed for a period of 4 hours. Results-Infusion of lipopolysaccharide res ulted in a severe hypodynamic circulatory slate, with significant decr eases in mean arterial pressure and cardiac output concurrent with a s ignificant increase in pulmonary arterial pressure. Hemofiltration was not associated with any correction of lipopolysaccharide-induced card iopulmonary derangements. Conclusions-Continuous venovenous hemofiltra tion, as used in this acute experiment, did not improve cardiopulmonar y dysfunction during endotoxic shock. Clinical Relevance-Continuous ve novenous hemofiltration needs further investigation before it can be r ecommended as a clinically effective treatment.