Continuous veno-venous hemofiltration with dialysis removes cytokines from the circulation of septic patients

作者：Rinaldo Bellomo, Peter G. Tipping, Neil Boyce · 发表于：Critical Care Medicine · 年份：1993 · DOI：10.1097/00003246-199304000-00011 · 被引用次数：372 · 研究领域：Acute Kidney Injury Research、Sepsis Diagnosis and Treatment、Dialysis and Renal Disease Management

OBJECTIVE: To determine whether continuous veno-venous hemofiltration with dialysis leads to extraction of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) from the circulation of critically ill patients with sepsis and acute renal failure and to quantitate the clearance and removal rates of these cytokines and their effect on serum cytokine concentrations. DESIGN: Prospective, controlled study of TNF-alpha IL-1 beta extraction by continuous veno-venous hemofiltration with dialysis in patients with septic acute renal failure. SETTING: Intensive care unit of a tertiary institution. PATIENTS: Eighteen critically ill patients with sepsis and acute renal failure. Control group of six patients experiencing an acute illness while undergoing chronic hemodialysis. INTERVENTIONS: Collection of blood samples before continuous veno-venous hemofiltration with hemodialysis. Simultaneous collection of prefilter blood and ultradiafiltrate after 4 and 24 hrs of treatment. MEASUREMENTS AND MAIN RESULTS: TNF-alpha and IL-1 beta concentrations were measured in blood and ultradiafiltrate. Their clearances and daily extraction were calculated and compared with a control group. TNF-alpha was detected in 66.6% of serum samples of patients with septic acute renal failure; IL-1 beta was detected in 55% of patients' sera samples. Both TNF-alpha and IL-1 beta were cleared by the hemofilter during continuous veno-venous hemofiltration with dialysis. The mean clearance for TNF-a...