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Cytokine Removal with a Large Pore Cellulose Triacetate Filter: An Ex Vivo Study

2002; SAGE Publishing; Volume: 25; Issue: 1 Linguagem: Inglês

10.1177/039139880202500105

1724-6040

S. Uchino, Rinaldo Bellomo, Donna Goldsmith, Piers Davenport, Louise Cole, Ian T. Baldwin, Sianna Panagiotopoulos, Peter G. Tipping, Claudio Ronco, P. Everard,

Cardiac and Coronary Surgery Techniques

Objective To test the hypothesis that hemofiltration using a new large pore cellulose triacetate hemofilter can achieve effective ultrafiltration of cytokines. Design Ex-vivo study. Setting Laboratory of Intensive Care Unit in tertiary hospital. Subjects Six healthy volunteers. Interventions Blood from 6 volunteers was incubated for 4 hours with 1 mg of endotoxin and then circulated through a closed hemofiltration circuit with a large pore cellulose triacetate hemofilter (nominal cut-off point: 60 kilodaltons). Hemofiltration was conducted at 1 L/h or 6 L/h of ultrafiltrate (UF) flow at the start of extra-corporeal circulation, and after 2 and 4 hours. Samples were taken from the arterial, venous and UF sampling ports. Measurements and main Results IL-Iβ, IL-6, IL-8, IL-10, TNFα, and albumin were measured. Sieving coefficients (SC) above 0.6 were achieved for IL-Iβ and IL-6 and SCs above 0.3 were achieved for IL-8 and TNF-α at 1 L/h. Sieving coefficients of all cytokines (except IL-10, p=0.22) were reduced when the ultrafiltration rate was increased from IL/h to 6 L/h (p<0.01), but the increase in ultrafiltration rate resulted in an overall increase in the clearance of all cytokines (p<0.001). The highest SC for albumin was 0.07 at 4 hours at 1 L/h, and fell to 0.01 at 6 L/h. The SCs for IL-8 fell at 4 hours (p<0.01), but the SCs for other cytokines did not change. No adsorption of cytokines and albumin was observed. Conclusion High volume hemofiltration (HVHF) using a new large pore cellulose triacetate filter achieved cytokine clearances greater than those reported with currently available hemofilters.