Super high flux hemofiltration: A new technique for cytokine removal

S. Uchino, R. Bellomo, D. Goldsmith, P. Davenport, L. Cole, I. Baldwin, S. Panagiotopoulos, P. Tipping

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Abstract

Objective: To test whether hemofiltration using a hemofilter with large pores (super high flux hemofiltration) achieves effective cytokine removal. Design: Ex vivo study. Setting: Laboratory of an intensive care unit in a tertiary hospital. Patients and participants: Five healthy volunteers. Interventions: Blood was spiked with 1 mg of endotoxin and then circulated through a closed hemofiltration circuit with a large pore polyamide super high flux he-mofilter (nominal cut-off point: 100 kDa). Hemofiltration was conducted at 1 l/h or 6 l/h of ultrafiltrate flow. Samples were taken from the arterial, venous and ultrafiltration sampling ports. Measurements and results: Sieving coefficients (SC) above 0.6 were achieved for interleukin (IL)-1β, IL-6 and IL-10 and SCs above 0.3 were achieved for IL-8 and TNF-α at 1 l/h. SCs of all cytokines (except IL-1) were reduced when the ultrafiltration rate was increased from 1 l/h to 6 l/h (p<0.01), but cytokine clearances still increased (p<0.01). The highest SC for albumin was 0.1 at 1 l/h and fell to 0.01 at 6 l/h. No adsorption of cytokines and albumin was observed. Conclusion: High volume ultrafiltration using a super high flux filter achieved cytokine clearances comparable to, or greater than, those currently achieved for urea during standard continuous renal replacement therapy.

Original languageEnglish
Pages (from-to)651-655
Number of pages5
JournalIntensive Care Medicine
Volume28
Issue number5
DOIs
Publication statusPublished - 17 Jun 2002
Externally publishedYes

Keywords

  • Acute renal failure
  • Cytokines
  • Hemofiltration
  • Interleukin
  • Polyamide
  • Sepsis

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