Elimination of procalcitonin and plasma concentrations during continuous veno-venous haemodiafiltration in septic patients

被引:19
作者
Meisner, M [1 ]
Hüttemann, E [1 ]
Lohs, T [1 ]
Kasakov, L [1 ]
Reinhart, K [1 ]
机构
[1] Univ Jena, Dept Anaesthesiol & Intens Care Therapy, D-07743 Jena, Germany
关键词
pathological processes; infection; sepsis; haemodialysis; haemodiafiltration;
D O I
10.1046/j.1365-2346.2000.00758.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The elimination of procalcitonin and the course of plasma concentrations during continuous venovenous haemodiafiltration were measured in patients with sepsis or multiple organ dysfunction syndrome, because these patients are a main target group for the measurement of procalcitonin and often require renal replacement therapy. Procalcitonin was measured in the prefilter plasma and the filtrate at 5 min, 15 min and 1, 2, 4, 6, 12, 24 h after set-up of continuous veno-venous haemodiafiltration. In a prospective study, 19 patients with plasma levels of procalcitonin >3 ng mL(-1) and acute oliguric renal failure treated with continuous veno-venous haemodiafiltration using a polysulphone membrane, were evaluated for the study of clearance. Twenty-one control patients (procalcitonin <2 ng mL(-1)) were studied to determine whether filtration itself induced a procalcitonin response. No interventions were required. In patients with low procalcitonin concentrations (procalcitonin < 2 ng mL(-1)) continuous veno-venous haemodiafiltration did not cause a rise in procalcitonin. In patients with increased procalcitonin plasma concentrations (> 3 ng mL(-1)), the protein was removed through the polysulphone membrane, with a final clearance of 4 mL min(-1) after the initial adsorption period (clearance 0.4-0.9 mL min(-1) during the first hour of continuous veno-venous haemodiafiltration). Thus, on the average, approximately 10% of plasma concentrations were measurable in the filtrate ultimately. However, procalcitonin plasma levels were not significantly altered during continuous veno-venous haemodiafiltration (86% of the initial concentration after 24 h). Although procalcitonin is removed from the plasma during continuous veno-venous haemodiafiltration in measurable amounts plasma procalcitonin concentrations did not change significantly during haemodiafiltration. Procalcitonin thus can also be used as a diagnostic parameter in patients undergoing continuous veno-venous haemodiafiltration.
引用
收藏
页码:665 / 671
页数:7
相关论文
共 17 条
[1]  
[Anonymous], 1999, J LAB MED
[2]  
*BAXT, 1999, BAXT REN 2 HEM PROD
[3]   DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ .
CHEST, 1992, 101 (06) :1644-1655
[4]  
GRAMM HJ, 1995, CHIR GASTROENTERO S2, V11, P51
[5]   Cytokine removal and cardiovascular hemodynamics in septic patients with continuous venovenous hemofiltration [J].
Heering, P ;
Morgera, S ;
Schmitz, FJ ;
Schmitz, G ;
Willers, R ;
Schultheiss, HP ;
Strauer, BE ;
Grabensee, B .
INTENSIVE CARE MEDICINE, 1997, 23 (03) :288-296
[6]   Effect of hemofiltration on hemodynamics and systemic concentrations of anaphylatoxins and cytokines in human sepsis [J].
Hoffmann, JN ;
Hartl, WH ;
Deppisch, R ;
Faist, E ;
Jochum, M ;
Inthorn, D .
INTENSIVE CARE MEDICINE, 1996, 22 (12) :1360-1367
[7]   Comparison of procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations at different SOFA scores during the course of sepsis and MODS [J].
Meisner, M ;
Tschaikowsky, K ;
Palmaers, T ;
Schmidt, J .
CRITICAL CARE, 1999, 3 (01) :45-50
[8]  
Meisner M, 1997, EUR J CLIN CHEM CLIN, V35, P597
[9]  
MEISNER M, 1996, PCT PROCALCITONIN NE
[10]  
MEISNER M, 2000, IN PRESS SHOCK