Effect of continuous high volume hemofiltration on respiratory mechanics,hemodynamics and thoracic fluid content in acute respiratory distress syndrome

Objective To investigate the effects of continuous high volume hemofiltration(CHVHF) on respiratory mechanics,hemodynamics and thoracic fluid content(TFC) in acute respiratory distress syndrome(ARDS).Methods 12 adults with ARDS received mechanical ventilation and CHVHF(6 L/h) for 72 hours.The cardiac output(CO),systemic vascular resistance(SVR),pulmonary vascular resistance(PVR),mean pulmonary arterial pressure(mPAP) and pulmonary artery wedge pressure(PAWP) were measured by Swan-Ganz catheter and the thoracic fluid content was measured with Bioz~() Cardio Dynamics.Concentrations of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8 and IL-10 were measured by ELISA before and after CHVHF.Results There were significant decrements in concentrations of TNF-α,IL-6 and IL-8 after CHVHF for 72 hours(P0.05),and in PVR after CHVHF for 48 hours and mPAP after CHVHF for 72 hours(P0.05).The TFC began to decrease at 24 hours with amelioration of PaO_2/FiO_2 and peak airway pressure(P0.05).(Conclusion) CHVHF shows significant beneficial effects on pulmonary function of ARDS as result of removal of inflammatory cytokines and reduction of TFC.