| Objective In clinical conditions,we studied the effect of continuous high volume hemofiltration(CHVHF)on immune system in patients with multiple organ dysfunction syndrome(MODS).Methods 12 patients with MODS who treated of CHVHF between Jul.2007 and Sep.2007 was studied.All of the 12 patients treated of CHVHF with a polysulfone filter(AV600S).The ultrafiltrate rate were 8000 ml/h and the blood flow was 200 ml/min.The substitute fluid was infused with pumps pre and post filter.We collected the blood samples of patients before CHVHF,when blood flow was 20ml/min after CHVHF 1st time and 2nd time.Serum levels of IL-6 and IL-10 were detected by ELISA(enzyme linked immunosorbent assay). Serum levels of CRP were detected by immunoturbidimetry.Phagocytic functions of PMN were detected by bacterium phagocytosis.APACHE(acute physiology and chronic health evaluate)Ⅱscores were measured before and after CHVHF.Results Compared with pre-treatment,mean arterial pressure(MAP)was did not change(P＞0.05)and heart rate(HR)was decreased(P＜0.05)after two times of CHVHF in MODS patients.Serum levels of creatinine were decreased after two times of CHVHF in MODS patients(P＜0.05).Serum levels of IL-6 were decreased after two times of CHVHF(P＜0.05)and serum levels of IL-10 were not changed after CHVHF(P＞0.05).Serum levels of CRP were also not changed after CHVHF(P＞0.05).Phagocytic function of PMN were strengthen during CHVHF(P＜0.05).Scores of APACHEⅡwere decreased after two times of CHVHF(P＜0.05).Conclusions CHVHF has satisfactory hemodynamics.CHVHF could decrease serum creatinine,remove the inflammatory cytokine IL-6 in serum and lighten inflammatory reaction,strengthen the phagocytic function of PMN, enhance cell immunocompetent and decrease the scores of APACHEⅡin patients with MODS.So,our results suggest that CHVHF was a safe and effective therapeutic method for MODS and this may due to its immune modulator effects. |
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