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Chinese Journal of Blood Purification ›› 2006, Vol. 5 ›› Issue (11) : 769-772.

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Abstract

Objective To evaluate prospectively the effect of continuous blood purification(CBP) on inflammatory mediators and oxidative stress in survivors and non-survivors with multiple organ dysfunction syndrome(MODS) and acute renal failure(ARF) after cardiac surgery. Methods Sixteen patients with MODS and ARF after cardiac surgery were treated with CBP(used HF700 hemofilter), and were divided into two groups: Eight survivors(group A) and eight non-survivors (group B).The serum levels of TNF-α, IL-6, IL-8, IL-4, malondialdehyde(MDA), superoxide dismutase(SOD) and total anti-oxidant capacity(TAC) before the start of CBP and after CBP for 2, 6, 12, 24 and 48 hours were examined and registered. Results After a 2 hours’ treatment of CBP, there was a significant reduction of the serum levels of TNF-α and IL-6, and after 24 hours’ IL-8 was significantly decreased in the group A; but there were no significant decrease in the group B. During a 48 hours treatment of CBP, there was no significant reduction of the serum levels of IL-4 in the both groups. In group A, after a 6 hours treatment of CBP, TAC was significantly reduced, after 12 hours, MDA was significantly decreased, and after 24 hours SOD was significantly decreased. In group B,after a 2 hours’ treatment of CBP, SOD and TAC was significantly reduced, MDA was remain in higher levels during the whole process of CBP. Conclusion CBP can improve the imbalance of oxidative and anti-oxidative systems and reduce damage caused by inflammatory mediators. CBP can improve the imbalance of proinflammatory cytokine and anti-inflammatory cytokine and reduce damage caused by inflammatory mediators. During the process of CBP, the prognosis is poor when the serum levels of TNF-α, IL-6, IL-8 and MDA are sustained high while SOD is significantly decreased early. The ambulatory examination of serum levels of those markers may be valuable for evaluating prognosis of patients with MODS and ARF after cardiac surgery.