Department of Physiology, Charles University, Faculty of Medicine and Teaching Hospital in Plzen, Plzen, Czech Republic.
Shock. 2010 Jan;33(1):101-5. doi: 10.1097/SHK.0b013e3181ab6359.
The aim was to investigate effects of continuous hemofiltration (CHF) and of coupled plasma filtration adsorption (CPFA) on electrophysiological properties of the septic heart. Sepsis was induced in anesthetized pigs by fecal peritonitis and continued for 22 h either without intervention (control sepsis) or with intervention (CHF or CPFA) applied for the last 10 h of this period. Electrocardiograms were recorded at baseline, before induction of peritonitis, and 22 h later, at the end of in vivo experiment. In vitro, action potentials were recorded in right ventricular trabeculae. RR, QT, and QTc (QT corrected for heart rate) intervals were shortened by sepsis. Action potential durations (APDs) were shortened by CHF, but not by CPFA, compared with control sepsis. Continuous hemofiltration prolonged APD. Coupled plasma filtration adsorption filtrate did not exert any effect on APD. Plasma separated during CPFA prolonged APD. Continuous hemofiltration shortened cardiac repolarization, and this effect was reversed by the hemofiltrate. In contrast, neither CPFA nor the CPFA filtrate influenced APD. The data indicate that some inflammatory mediators able to delay cardiac repolarization were removed from plasma to hemofiltrate by CHF but not by CPFA.
目的是研究连续血液滤过（CHF）和联合血浆滤过吸附（CPFA）对脓毒症心脏电生理特性的影响。通过粪便性腹膜炎在麻醉猪中诱导脓毒症，并在没有干预（对照性脓毒症）或在该期间的最后 10 小时进行干预（CHF 或 CPFA）的情况下继续进行 22 小时。在基线、腹膜炎诱导前和 22 小时后（体内实验结束时）记录心电图。在右心室小梁中记录动作电位。与脓毒症相比，RR、QT 和 QTc（心率校正的 QT）间隔缩短。与对照性脓毒症相比，CHF 缩短了动作电位持续时间（APD），但 CPFA 并未缩短。连续血液滤过延长了 APD。CPFA 滤过液对 APD 没有任何影响。CPFA 分离的血浆延长了 APD。连续血液滤过缩短了心脏复极，这种作用被血液滤过液逆转。相比之下，CPFA 或 CPFA 滤过液均未影响 APD。这些数据表明，一些能够延迟心脏复极的炎症介质通过 CHF 从血浆转移到血液滤过液中，但不能通过 CPFA。
