Evaluation of myoglobin clearance during continuous hemofiltration in a swine model of acute renal failure
Evaluation of myoglobin clearance during continuous hemofiltration in a swine model of acute renal failure
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DOI：
10.1177/039139889601901004
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发表时间：
1996-10-01
影响因子：
1.7
通讯作者：
Nightingale, CH
中科院分区：
文献类型：
--
作者：
Nicolau, DP;Feng, YJ;Nightingale, CH
横纹肌溶解的特点是横纹肌的广泛损害，而这种疾病的主要并发症是急性肌红蛋白尿肾功能衰竭的发展。虽然第一次描述是在50多年前，但由于传统的血液透析没有显示出对肌红蛋白消除的影响，因此对这种实体的管理几乎没有改变。然而，连续动静脉血液滤过（CAVH）提供了一种替代传统血液透析的方法，因为这种方法更有效，特别是对于去除较大分子量的物质，如肌红蛋白。我们在急性肌红蛋白尿性肾衰竭动物模型中研究了CAVH对肌红蛋白清除的影响。猪（n=6）静脉注射4克马肌红蛋白，每只进行6小时CAVH手术。一旦过滤过程开始，超滤液就会迅速而持续地产生。血液滤器对肌红蛋白的清除率为2.05+/-1.48 L/d。在6小时的过滤期间，超滤液中肌红蛋白的排泄量为410+/-234 mg，占给药剂量的10.27+/- 5.85%。基于这些发现，血液滤过系统似乎是清除体循环中肌红蛋白的可行选择。
Rhabdomyolysis is characterized by extensive damage of striated muscle, while the major complication of this disease is the development of acute myoglobinuric renal failure. Although first described more than five decades ago very little has changed with regard to the management of this entity as conventional hemodialysis has not been shown to effect myoglobin elimination. However, continuous arteriovenous hemofiltration (CAVH) offers an alternative to conventional hemodialysis as this procedure is more effective particularly for removing larger molecular weight substances such as myoglobin. We studied the effect of CAVH on myoglobin clearance in an animal model of acute myoglobinuric renal failure. Swine (n=6) were given 4 grams of equine myoglobin intravenously and underwent the CAVH procedure for six hours each. Once the filtering process was initiated there was a rapid and sustained production of ultrafiltrate. The clearance of myoglobin via the hemofilter was 2.05+/-1.48 L/day. The amount of myoglobin excreted in the ultrafiltrate over the six hour filtering period was 410+/-234 mg which accounts for 10.27+/-5.85 percent of the administered dose. Based on these findings, it appears that the hemofiltration system is a viable option for the removal of myoglobin from the systemic circulation.