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Related Experiment Videos

hemofiltration reverses left ventricular dysfunction during sepsis in dogs.

A Gomez1, R Wang, H Unruh

  • 1Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.

Anesthesiology
|October 1, 1990
PubMed
Summary

Sepsis can depress heart function due to a circulating factor. Hemofiltration effectively removed this cardiodepressant factor, restoring left ventricular contractility in dogs.

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Area of Science:

  • Cardiovascular Physiology
  • Sepsis Pathophysiology
  • Renal Replacement Therapy

Background:

  • Sepsis-induced myocardial depression is a critical complication.
  • The role of circulating cardiodepressant substances (FCS) in sepsis is debated.
  • Existing treatments for sepsis-related cardiac dysfunction are limited.

Purpose of the Study:

  • To investigate the hypothesis that a filterable cardiodepressant substance causes sepsis-induced left ventricular (LV) dysfunction.
  • To determine if hemofiltration can reverse LV dysfunction during experimental sepsis.
  • To characterize the nature of the putative cardiodepressant substance.

Main Methods:

  • Anesthetized dogs received continuous intravenous infusion of live Escherichia coli to induce sepsis.

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  • Left ventricular (LV) dimensions were measured using implanted ultrasonic crystals.
  • LV contractility was assessed by the end-systolic pressure-dimension relationship (Emax).
  • Hemofiltration was performed to remove circulating substances.
  • Plasma FCS activity was measured using isolated canine right ventricular trabeculae.

    • Main Results:

    • Sepsis significantly reduced LV contractility (Emax) by 50% after 4 hours.
    • Hemofiltration restored Emax to baseline control values.
    • Peak FCS activity was observed at 4 hours of sepsis and decreased after hemofiltration.
    • The cardiodepressant substance has a molecular weight of less than 30,000 Daltons.

    Conclusions:

    • A circulating cardiodepressant substance contributes to LV dysfunction in experimental sepsis.
    • Hemofiltration is an effective method for removing this substance and improving cardiac contractility.
    • These findings support the potential therapeutic role of hemofiltration in managing sepsis-induced myocardial depression.