Continuous removal of leucocytes during early gram-negative septicemia reduces plasma levels of endotoxin and improves cardiac performance.

The effect of filter leucapheresis as treatment of gram-negative septicemia was studied in an experimental porcine model. In 7 matched pairs of animals, one of the animal groups received filter leucapheresis starting 2 h after the induction of septicemia. The other animal group acted as a non-treated control. A calculated mean number of 15 x 10(9) white blood cells were removed. Animals submitted to leucapheresis showed lower levels of circulating endotoxin, diminished degree of granulocyte activation and higher cardiac output when compared to the non-treated controls. The increased cardiovascular performance indicated a beneficial effect of selective leucafiltration during early gram-negative septicemia. Lower levels of circulating endotoxin and less active PMNs might contribute to these changes.