Introduction
Material and methods
Haemofiltration setting
Protocol
Statistical analysis
Results
Systemic haemodynamics, oxygen exchange, acid–base data and metabolism
Baseline | 12 h | 18 h | 22 h | |
---|---|---|---|---|
MAP (mmHg) | ||||
CON | 94 (89; 104) | 93 (85; 102) | 85 (80; 102) | 76 (74; 92)a
|
HF | 84 (82; 96) | 88 (84; 94) | 92 (88; 103) | 78 (71; 81) |
HVHF | 94 (87; 100) | 98 (84; 113) | 91 (76; 98) | 81 (72; 91) |
CO (ml/kg) | ||||
CON | 70 (61; 88) | 108 (94; 122)a
| 114 (107; 128)a
| 147 (99; 183)a
|
HF | 73 (72; 85) | 125 (102; 131)a
| 129 (112; 134)a
| 136 (126.162)a
|
HVHF | 74 (68; 80) | 106 (92; 117)a
| 111 (107; 135)a
| 131 (126.155)a
|
MPAP (mmHg) | ||||
CON | 26 (23; 27) | 34 (30; 36)a
| 35 (34; 40)a
| 38 (36; 43)a
|
HF | 27 (25; 47) | 30 (29; 48)a
| 34 (31; 67)a
| 34 (32; 59)a
|
HVHF | 25 (22; 29) | 29 (27; 39)a
| 34 (31; 37)a
| 40 (31; 47)a
|
SVR (dyne s/cm−5) | ||||
CON | 2774 (2524; 2839) | 1717 (1467; 1956)a
| 1361 (1068; 1837)a
| 851 (719; 1514)a
|
HF | 2201 (1914; 2889) | 1275 (1191; 1964)a
| 1276 (1172; 1669)a
| 929 (858; 1276)a
|
HVHF | 2447 (2070; 2734) | 1782 (1589; 2014) | 1340 (1158; 1583)a
| 1161 (830; 1326)a
|
ITBV (ml/kg) | ||||
CON | 22 (19; 33) | 25 (19; 31) | 26 (21; 28) | 22 (18; 30) |
HF | 25 (20; 29) | 30 (24; 30) | 25 (21; 25) | 26 (25; 27) |
HVHF | 19 (17; 25) | 24 (22; 26) | 26 (21; 28) | 27 (25; 28) |
DO2 (ml/min per kg) | ||||
CON | 9 (8; 13) | 15 (14; 18)a
| 16 (15; 20)a
| 24 (16; 24)a
|
HF | 10 (8; 11) | 18 (12; 18)a
| 17 (16; 18)a
| 16 (15; 17)a
|
HVHF | 10 (9; 11) | 15 (13; 15)a
| 14 (13; 15)a
| 15 (13; 16)a
|
VO2 (ml/min per kg) | ||||
CON | 5 (4; 6) | 6 (5; 9) | 6 (5; 7) | 7 (6; 9) |
HF | 5 (4; 6) | 6 (4; 7) | 6 (5; 7) | 5 (5; 6) |
HVHF | 4 (4; 5) | 6 (5; 6) | 5 (5; 6) | 5 (5; 6) |
Arterial pH | ||||
CON | 7.52 (7.50; 7.54) | 7.47 (7.44; 7.49)a
| 7.45 (7.43; 7.50)a
| 7.36 (7.32; 7.41)a
|
HF | 7.50 (7.48; 7.54) | 7.49 (7.46; 7.50) | 7.48 (7.46; 7.49) | 7.45 (7.40; 7.48) |
HVHF | 7.53 (7.50; 7.55) | 7.46 (7.43; 7.52)a
| 7.45 (7.43; 7.47)a
| 7.40 (7.36; 7.48)a
|
Base excess (mmol/l) | ||||
CON | 5.7 (4.5; 6.6) | 5.5 (4.7; 5.9) | 4.2 (2.5; 5.9) | 1.4 (−1.5; 1.4)a
|
HF | 6.8 (5.2; 8.6) | 7.2 (5.1; 8) | 5.3 (3.4; 6.6) | 4.4 (0.8; 5.8)a
|
HVHF | 7.9 (5.5; 8.4) | 5.5 (3.9; 6.2) | 4.3 (3.2; 4.9) | 2 (1.3; 6.4)a
|
Core temperature (°C) | ||||
CON | 38.0 (37.0; 38.3) | 40.2 (39.1; 41.3)a
| 39.6 (38.7; 40.3) | 39.5 (38.0; 40.4) |
HF | 38.2 (37.2; 39.3) | 39.7 (39.0; 40.5)a
| 38.7 (38.0; 38.8) | 38.5 (38.0; 38.8) |
HVHF | 37.6 (35.3; 38.0) | 39.6 (37.8; 39.8)a
| 37.7 (37.4; 38.1) | 37.5 (37.4; 38.1) |
Oxygenation index (PaO2/FiO2) | ||||
CON | 416 (345; 475) | 409 (289; 490) | 283 (267; 396)a
| 160 (94; 271)a
|
HF | 491 (439; 509) | 365 (292; 445)a
| 349 (259; 454)a
| 238 (174; 294)a
|
HVFH | 467 (396; 495) | 437 (360; 499) | 289 (230; 347)a
| 156 (72; 321)a
|
Arterial lactate/pyruvate ratio | ||||
CON | 11 (7; 19) | 18 (11; 22) | 17 (15; 36) | 31 (20; 46)a
|
HF | 12 (11; 14) | 10 (7; 14) | 9 (8; 20) | 28 (19; 56)a
|
HVFH | 13 (11; 17) | 15 (8; 29) | 22 (14; 53)a
| 60 (29; 87)a
|
Regional haemodynamics, microcirculation, metabolism and organ function
Baseline | 12 h | 18 h | 22 h | |
---|---|---|---|---|
Q liver (ml/kg per min) | ||||
CON | 27 (21; 28) | 35 (31; 37)a
| 28 (27; 33) | 24 (19; 28) |
HF | 20 (20; 23) | 30 (26; 38) | 33 (26; 40) | 29 (18; 38) |
HVFH | 27 (24; 29) | 34 (27; 38) | 34 (31; 42) | 36 (26; 38) |
Liver DO2 (ml/min per kg) | ||||
CON | 1.8 (1.6; 2.2) | 4.4 (4.1; 4.6)a
| 4.1 (3.6; 4.7)a
| 3.4 (2.9; 4.1)a
|
HF | 1.3 (1.0; 1.7) | 4.1 (2.8; 4.4)a
| 3.9 (3.0; 4.7)a
| 3.3 (2.6; 4.1)a
|
HVFH | 1.9 (1.7; 2.2) | 3.4 (3.3; 4.4)a
| 4.0 (3.5; 4.4)a
| 3.1 (2.9; 3.8)a
|
Liver VO2 (ml/min per kg) | ||||
CON | 1.0 (0.8; 1.1) | 1.0 (0.6; 1.5) | 1.1 (0.8; 1.2) | 1.1 (1.0; 1.3) |
HF | 0.8 (0.5; 0.9) | 0.9 (0.7; 1.0) | 0.9 (0.7; 1.1) | 1.0 (0.8; 1.3) |
HVFH | 0.7 (0.6; 0.8) | 1.0 (0.8; 1.2) | 0.8 (0.6; 1.0) | 0.8 (0.7; 1.4) |
pH HV | ||||
CON | 7.44 (7.43; 7.46) | 7.38 (7.37; 7.42)a
| 7.39 (7.37; 7.41)a
| 7.31 (7.28; 7.36)a
|
HF | 7.42 (7.39; 7.47) | 7.43 (7.40; 7.43) | 7.41 (7.34; 7.43) | 7.41 (7.35; 7.42) |
HVFH | 7.45 (7.42; 7.49) | 7.36 (7.34; 7.48) | 7.40 (7.38; 7.42) | 7.41 (7.35; 7.41) |
Serum ALT levels (nkat/g protein) | ||||
CON | 12 (12; 15) | 11 (11; 16) | 12 (12; 18)a
| 19 (12; 19)a
|
HF | 12 (10; 13) | 12 (11; 15) | 15 (12; 16)a
| 14 (12; 17)a
|
HVFH | 15 (9; 16) | 12 (11; 16) | 13 (11; 16) | 15 (10; 17) |
Q renal artery (ml/kg per min) | ||||
CON | 6 (4; 6) | 7 (5; 8) | 7 (5; 7) | 4 (4; 6) |
HF | 5 (4; 6) | 7 (6; 10) | 6 (5; 8) | 6 (4; 9) |
HVFH | 7 (3; 9) | 6 (3; 8) | 4 (3; 9) | 4 (2; 10) |
Renal DO2 (ml/min per kg) | ||||
CON | 0.8 (0.6; 0.9) | 1.1 (0.8; 1.2) | 0.8 (0.7; 1.1) | 0.6 (0.5; 1.1) |
HF | 0.7 (0.5; 0.8) | 1.0 (0.7; 1.4) | 0.8 (0.7; 1.0) | 0.7 (0.5; 1.1) |
HVFH | 0.7(0.4; 1.4) | 0.8 (0.4; 1.1) | 0.5 (0.4; 1.0) | 0.5 (0.2; 1.2) |
Renal VO2 (ml/min per kg) | ||||
CON | 0.2 (0.1; 0.2) | 0.2 (0.1; 0.2) | 0.2 (0.2; 0.2) | 0.2 (0.1; 0.2) |
HF | 0.2 (0.1; 0.3) | 0.2 (0.2; 0.2) | 0.2 (0.1; 0.2) | 0.2 (0.2; 0.3) |
HVFH | 0.1 (0.1; 0.2) | 0.2 (0.1; 0.2) | 0.1 (0.1; 0.2) | 0.1 (0.04; 0.2) |
pH RV | ||||
CON | 7.50 (7.49; 7.51) | 7.42 (7.41; 7.47)a
| 7.46 (7.43; 7.47)a
| 7.35 (7.33; 7.39)a
|
HF | 7.49 (7.41; 7.51) | 7.45 (7.44; 7.48) | 7.46 (7.40; 7.48) | 7.44 (7.37; 7.46)a
|
HVFH | 7.54 (7.53; 7.54) | 7.47 (7.44; 7.51)a
| 7.43 (7.43; 7.44)a
| 7.40 (7.31; 7.44)a
|
Creatinine (μmol/l) | ||||
CON | 91 (91; 97) | 95 (81; 118) | 98 (88; 129) | 129 (94; 130) |
HF | 86 (79; 98) | 84 (75; 95) | 75 (62; 77)b
| 72 (67; 77)b
|
HVFH | 88 (78; 96) | 85 (75; 95) | 62 (56; 82)b
| 62 (51; 78)b
|
Ileal mucosal microcirculation (MFI) | ||||
CON | 3.0 (2.9; 3.0) | 2.9 (2.2; 3.0)a
| 2.4 (2,1; 2,7)a
| 2.2 (2.0; 2.3)a
|
HF | 3.0 (2.9; 3.0) | 2.4 (1.9; 2.8)a
| 2.8 (2.5; 3.0) | 2.5 (2.4; 2.7)a
|
HVFH | 3.0 (3.0; 3.0) | 3.0 (2.9; 3.0)a
| 2.3 (2.0; 2.5)a
| 2.5 (2.3; 2.9)a
|
Inflammation, oxidative/nitrosative stress and endothelial dysfunction (Table 3, Fig. 2 ESM)
Baseline | 12 h | 18 h | 22 h | |
---|---|---|---|---|
Plasma IL-6 levels (nmol/g protein) | ||||
CON | 115 (70; 205) | 555 (361; 650)a
| 1298 (504; 2405)a
| 2329 (821; 9805)a
|
HF | 72 (22; 187) | 292 (262; 426)a
| 1432 (487; 2256)a
| 978 (786; 4048)a
|
HVFH | 148 (110; 265) | 317 (173; 901)a
| 567 (312; 2259)a
| 985 (543; 10771)a
|
Plasma TNF-α levels (nmol/g protein) | ||||
CON | 1 (1; 1) | 5 (5; 9)a
| 11 (6; 18)a
| 18 (6; 23)a
|
HF | 1 (0; 2) | 5 (3; 7)a
| 6 (3; 10)a
| 13 (5; 18)a
|
HVFH | 2 (0; 2) | 3 (2; 8)a
| 5 (3; 7)a
| 6 (4; 9)a
|
Plasma TBARS levels (nmol/g protein) | ||||
CON | 19 (15; 22) | 47 (38; 60)a
| 77 (55; 89)a
| 66 (54; 98)a
|
HF | 17 (16; 22) | 50 (45; 51)a
| 60 (49; 71)a
| 72 (53; 88)a
|
HVFH | 17 (15; 19) | 45 (35; 71)a
| 55 (43; 85)a
| 53 (42; 80)a
|
Plasma ADMA levels (nmol/g protein) | ||||
CON | 54 (46; 68) | 87 (73; 94) | 118 (56; 141) | 53 (46; 120) |
HF | 50 (42; 57) | 53 (38; 79) | 41 (36; 97) | 61 (45; 128) |
HVFH | 48 (42; 59) | 80 (71; 93) | 75 (46; 128) | 97 (50; 117) |
GSH/GSSG | ||||
CON | 9 (7; 10) | 15 (12; 25) | 25 (13; 33) | 142 (30; 375)a
|
HF | 14 (10; 19) | 18 (15; 47) | 41 (23; 201) | 148 (56; 497)a
|
HVFH | 10 (8; 12) | 32 (13; 33) | 28 (22; 63) | 106 (28; 204)a
|