Manns M, Sigler MH, Teehan BP
Continuous veno-venous hemodialysis in septic patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:497 1995
These authors attribute hemodynamic improvement in CRRT to
cytokine removal. They recorded mean arterial pressure (MAP) in 10
patients with sepsis and ARF treated with CVVHD (BFR 120 ml/min, UFR 80-150
ml/hr) for 12 hours preceding and 16 hours
during CVVHD. MAP improved 4-6 hours following initiation of
CVVHD and then returned to baseline in 9 hours with no change in
volume, vasopressor or inotropes; indirect evidence that
possibly cytokine removal secondary to membrane adsorption may have
accounted for the improvement.
Comment: Although membrane adsorption and subsequent release has
been demonstrated previously it has been
most prominent with PAN membranes. In the absence of cytokine
assays evidence for cytokine removal appears to be indirect at best.
(Mehta)
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Am Soc Nephrol
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