| Severe cerebral edema is a pathophysiologic events with extremely high mortality. The therapy of cerebral edema is always the important research task in clinical and basic works. Whatever the cerebral edema was cause by injure or ischemia, the onset and development has the same pathologic and pathophysiologic mechanism. Recently research found that severe cerebral edema closely related to the central nervous system and systemic inflammatory respond syndrome (SIRS), which were triggered by local injure, end toxin and organ ischemic reperfusion, etc. The mechanism of SIRS is connected to microcirculation dysfunction and the function of pro-cytokines ,such as tumor necrosis factor-(TNF- a ) and interleukins (IL-1,6,8), which are secreted by active macrophage cell.Meanwhile, the those cytokines also induce secondary inflammatory medium release exceedingly, including nit oxide (NO), oxide radical, exciting amino acids, calcium overload, which may media or participate in the expression of neuron medium, membrane receptor gene, and influent the intracellular signal transduction substance, protein kinase, ultimately the cerebral edema, neuron necrosis and apoptosis happen. Furthermore this respond process and the medium also interpose other organ and system dysfunction, such as unbalance in body fluid and metabolism, circulation failure, respiratory failure, renal failure, infection and multiple organ dysfunction (MODS), also aggravate the onset and development of cerebral edema, this vicious circle is the key for the worse prognosis of severe cerebral edema. Clinic scholarshave adopted different medicine and therapy to inhibit this response process, in order to cut down the damage and cure the cerebral edema, calcium blocker; corticosteroids, cytokine antibodies and mile hypothermia have been used. Since the response process is caused by multiple factors, the treatment aiming at mono-factor on cerebral edema was not ideal. At present, the treatment on cerebral edema is still using the dehydrator (hyperosmotic and diuretic) to recede the intracranial pressure, but the in influence on fluid balance, renal function or circulation have been acknowledged, there is not other better dehydration technique to take place of dehydrator yet.High volume hemoflitration (HVHF) is a new technique of continuous blood purification. HVHF has powerful convection function, can eliminate middle molecular weigh of most substance (<30.000 Daltons), such as quantitative inflammatory medium, cytokines, and consequently ameliorate the inflammatory process. Meanwhile, HVHF remove the water osmotically and be easily controlled. With CBP, the temperature can be controlled primly; the internal environment can be modulated more accurately. These modifications are aimed at moving HVHF from the simple treatment of ARF, CRF to the adjunctive treatment of SIRS, MODS, ARDS and acute pancreatitis.The native and overseas scholar found that hemofiltration could use in the renal failure complicating with cerebral edema. Using the HVHF on experimental animal model with reperfusion injury after bran ischemia, lactic acid and small molecular substance were cleared efficaciously. HVHF used in diuretic -resistant pulmonary edema of congestive cardiac failure also was proved that it has high efficient of dehydration and removal for cytokines.There is no report on the effect of the HVHF used on severe cerebral edema without renal failure, and the effect on the temperature, vital sign, circulating and internal environment. Our study objective is following:1. To investigate the hypothermia effect of the HVHF in treatment ofcerebral edema in animal model after injury is the heat exchange between theexreacorporeal circulation and the plenty replacement fluid;2. To study the effect of HVHF on the clearance of substance with different molecule weigh and the influence of internal environment and homodynamic, to prove whether the HVHF and be a safe technique on mile hypothermia;3. To investigate the influence and mechanism of HVHF on the pa...
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