Cytokines in Plasma and Ultrafiltrate during Continuous Arteriovenous Haemofiltration

Open Access
Publisher Website
Google Scholar
Abstract
Cytokines are considered to be important mediators in the pathophysiology of sepsis and septic shock. We investigated if continuous arteriovenous haemofiltration (CAVH) could be used to remove excessive amounts of the cytokines tumour necrosis factor-α (TNFα), interleukin (IL)-1α and IL-6 from peripheral blood in critically ill patients. Nine septic patients with renal failure were treated with CAVH. Ultrafiltrate and plasma were tested for cytokines by ELISA. All patients had detectable TNFα and IL-6 plasma levels, ranging from 10-750 pg/ml and 50-4,575 pg/ml, respectively. TNFα was removed by the ultrafiltrate with concentrations ranging from 10-1,000 pg/ml. The TNFα levels were significantly higher in the ultrafiltrate samples than in the corresponding plasma samples (P <0.003). IL-6 was undetectable in the ultrafiltrate from five of the patients despite concomitant high plasma levels. IL-1α was detectable in both plasma and ultrafiltrate in four patients. All patients developed multi-organ failure and septic shock and seven died. It is concluded that TNFα and IL-1α but not IL-6 can be removed by CAVH in patients with sepsis.