Effct of Continuous Plasmafiltter Hemodialysis in Experimental Endotoxic Shock

为了评估连续质滤血液透析（CPFD）对内毒素性休克血流动力学的影响，对34头猪（20-25kg）进行了内毒素血症试验。注射0.1 mg/kg内毒素后，随机分为5组：1)对照组，只注射内毒素（n=8）；2) CPFD组，采用血浆滤过器（Evaflux^<(R)>, Krare）作为透析器，透析液流速1000ml/hr (n=8)；3)假性CPFD组，观察体外循环本身的作用（n=6）；4)持续血液透析（CHD）组，使用标准膜透析器（MA10U^<(R)>, Kawasumi） （n=6）；5)连续血液滤过（CHF）组，采用聚砜膜血液滤过器（PS-P^<(R)>, Krare），超滤速率1000ml/hr （n=6）。与对照组相比，所有血液净化治疗组（CPFD组、Sham CPFD组、CHF组、CHF组）在血流动力学反应（平均血压、心率、心输出量、全身血管阻力、肺动脉压、肺动脉闭塞压）方面均无差异。本研究未发现CPFD对实验性内毒素休克的血流动力学有明显影响。

In order to asses the effect of continuous plasmafilter hemodialysis (CPFD) on hemodynamics in endotoxin induced shock, endotoxinemia was invoked in 34 swine (20-25kg). After infusion of 0.1 mg/kg endotoxin, the animals were randomly divided into 5 groups : 1) a control group, received endotoxin only (n=8) ; 2) CPFD group, in whom plasmafilter (Evaflux^<(R)>, Krare) was used as a dialyzer and the dialysite flow rate was 1000ml/hr (n=8) ; 3) Sham CPFD group, in whom the effect of the extracorporeal circuit itself was observed (n=6) ; 4) Continuous hemodialysis (CHD) group, in whom a standard membrane dialyzer (MA10U^<(R)>, Kawasumi) was used (n=6) ; 5) Continuous hemofiltration (CHF) group, in whom polysulfone membrane hemofilter (PS-P^<(R)>, Krare) was used and the ultrafiltration rate was 1000ml/hr (n=6).Compared with the control group, none of the blood purification therapy groups (the CPFD group, the Sham CPFD group, the CHF group, the CHF group) showed any difference in hemodynamic response (mean blood pressure, heart rate, cardiac output, systemic vascular resistance, pulmonary arterial pressure, pulmonary artery occlusion pressure). In this study, no significant hemodynamic influence of CPFD was observed in experimental endotoxic shock.