Dose-related effects of direct hemoperfusion using a cytokine adsorbent column for the treatment of experimental endotoxemia

Objective: To clarify the dose-related effects of direct hemoperfusion using a cytokine adsorbent column (CTR) on the mortality and inflammatory responses to endotoxin-induced shock in rats. Design: Prospective and randomized study. Setting: University research laboratory. Subjects: Male Wistar rats. Interventions: Forty-eight rats were injected intravenously with Escherichia coli endotoxin ( 15 mg/kg over 2 min), and then were randomly allocated to one of the following four groups ( n = 12 per group): control group, treated without CTR for 120 min; quarter-dose treatment group, treated with CTR 0.25ml for 120 min; half-dose treatment group, treated with CTR 0.50ml; and full-dose treatment group, treated with CTR 1.0 ml. Measurements and results: Hemodynamics and arterial blood gases were recorded, and mortality and plasma cytokine concentrations were calculated for the 8-h observation period. The mortality rates 8 h after endotoxin injection were 92%, 58%, 42% and 17% for the control column, quarter-dose, half-dose, and full-dose CTR groups, respectively. The increases in plasma cytokine concentrations were smaller in the half-dose and full-dose CTR treatment groups than in the endotoxemic group. Conclusions: The present study showed that CTR treatment dose-dependently decreased the mortality rate and inhibited inflammatory responses in vivo.