Effects of continuous venovenous hemodiafiltration on plasma LPS,IL -1β, IL -4, HMGB -1 in multiple organ dysfunction syndrome dogs

Objective To investigate the effects of continuous venovenous hemodiafiltration (CVVHDF) on plasma lipopolysaccharide (LPS), interleukin(IL) 1β, IL-4, high mobility group box 1 (HMGB-1) in multiple organ dysfunction syndrome (MODS ) dogs, to explore the therapeutic mechanism of CVVHDF. Methods Dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to establish MODS model, then they were randomly divided into 2 groups: CVVHDF group (n=6) and MODS group (n=6). After endotoxin injection completed, the CVVHDF group received CVVHDF treatment for 24 h; MODS group did not receive CVVHDF treatment. The LPS, IL-1β, IL-4, HMGB-1 levels in plasma and ultrafiltrate were measured at different time points(before operation, before intravenous infusion of endotoxin, 0 h, 3 h, 6 h, 9 h, 12 h, 18 h, 24 h after intravenous infusion completion of endotoxin), then the sieving coefficient (SC) was calculated. Results Compared with MODS group, the LPS, IL-1β, IL-4, HMGB-1 levels in plasma were significantly decreased in the CVVHDF group at 9 h, 12 h, 18h,24h(P ＜0.05).SomeconcentrationofIL-1β,IL-4andHMGB-1wasdetectedintheultrafiltrate,the SC for IL-1β, IL-4 and HMGB-1 was 0.60±0.12, 0.83±0.11, 0.70±0.09 respectively, and LPS could not be detected in the ultrafiltrate, its SC was 0. After treatment, the damage level of lung and renal had been significantly reduced in CVVHDF group. Conclusion CVVHDF can effectively reduce the levels of pro-inflammatory mediator and anti-inflammatory cytokine related to MODS, cut off the vicious circle of cytokine network and reduce the damage level of organism in the treatment of MODS.