Efficacy of convective removal of plasma mediators of endotoxic shock by continuous veno-venous hemofiltration

Continuous veno-venous hemofiltration (CWH) has been reported to provide beneficial effects during endotoxic shock. This experiment was designed to determine if selective removal of plasma mediators occurs during CWH and if plasma concentrations of these mediators are reduced. A swine endotoxic-shock model with three groups was used [lipopolysaccharide (LPS) only (n = 6); LPS followed by CWH (n = 6); and LPS followed by sham CWH (n = 4)]. Plasma and filtrate samples were collected at frequent intervals for 5 h. Lactic acid (LA), eicosanoids [prostacyclin (6-keto PGF(1 alpha)) thromboxane (TxB(2)), and prostaglandin E(2) (PGE(2))] and tumor necrosis factor (TNF) were measured in plasma and filtrate, Plasma concentrations of 6-keto PGF(1 alpha), TxB(2), TNF, and LA were not significantly different in any group. LA, PGE(2), 6-keto PGF(1 alpha), and TxB(2) concentrations were similar in filtrate and plasma, TNF did not move across the membrane into the filtrate, CWH, as used in this experiment, did not significantly reduce plasma concentrations of any of these mediators.