Christian Doppler Laboratory for Innovative Therapy Approaches in Sepsis, Donau University Krems, Krems an der Donau, Austria.
Blood Purif. 2017;44(4):260-266. doi: 10.1159/000478965. Epub 2017 Oct 7.
High cutoff hemofilters might support the restoration of immune homeostasis in systemic inflammation by depleting inflammatory mediators from the circulation.
Interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha depletion was assessed in 30 sepsis patients with acute renal failure using continuous veno-venous hemodialysis with high cutoff versus standard filters (CVVHD-HCO vs. CVVHD-STD) over 48 h.
The transfer of IL-6 and IL-8 was significantly higher for CVVHD-HCO, as shown by increased IL-6 and IL-8 effluent concentrations. The mean plasma cytokine concentrations decreased over time for all cytokines without detectable differences for the treatment modalities. No transfer of albumin was observed for either of the filters. C-reactive protein remained stable over time and did not differ between CVVHD-HCO and CVVHD-STD, while procalcitonin decreased significantly over 48 h for both treatment modalities.
CVVHD-HCO achieved enhanced removal of IL-6 and IL-8 as compared to CVVHD-STD, without differentially reducing plasma cytokine levels.
高通量血液滤过器通过从循环中清除炎症介质，可能有助于恢复全身炎症中的免疫稳态。
使用高通量血液滤过器（CVVHD-HCO）与标准血液滤过器（CVVHD-STD）对 30 例伴有急性肾功能衰竭的脓毒症患者进行连续静脉-静脉血液透析（CVVH）48 小时，评估白细胞介素（IL）-6、IL-8、IL-10 和肿瘤坏死因子-α的清除情况。
CVVHD-HCO 的 IL-6 和 IL-8 转移明显更高，表现为 IL-6 和 IL-8 流出浓度增加。所有细胞因子的血浆细胞因子浓度随时间降低，但治疗方式之间无差异。两种滤器均未观察到白蛋白的转移。C-反应蛋白随时间保持稳定，CVVHD-HCO 和 CVVHD-STD 之间无差异，而降钙素原在两种治疗方式下均显著降低 48 小时。
与 CVVHD-STD 相比，CVVHD-HCO 实现了对 IL-6 和 IL-8 的增强清除，而对血浆细胞因子水平无差异降低。
