Vasoactive intestinal peptide (VIP) is a neuropeptide released from the autonomic nerves exerting multiple antiinflammatory effects. The aim of the present study was to investigate the impact of severe sepsis and hemofiltration in two settings on plasma and tissue concentrations of VIP in a porcine model of sepsis. Thirty-two pigs were divided into 5 groups: 1) control group; 2) control group with conventional hemofiltration; 3) septic group; 4) septic group with conventional hemofiltration; 5) septic group with high-volume hemofiltration. Sepsis induced by faecal peritonitis continued for 22 hours. Hemofiltration was applied for the last 10 hours. Hemodynamic, inflammatory and oxidative stress parameters (heart rate, mean arterial pressure, cardiac output, systemic vascular resistance, plasma concentrations of tumor necrosis factor-alpha, interleukin-6, thiobarbituric acid reactive species, nitrate + nitrite, asymmetric dimethylarginine) and the systemic VIP concentrations were measured before faeces inoculation and at 12 and 22 hours of peritonitis. VIP tissue levels were determined in the left ventricle, mesenteric and coronary arteries. Sepsis induced significant increases in VIP concentrations in the plasma and mesenteric artery, but it decreased peptide levels in the coronary artery. Hemofiltration in both settings reduced concentrations of VIP in the mesenteric artery. In severe sepsis, VIP seems to be rapidly depleted from the coronary artery and, on the other hand, upregulated in the mesenteric artery. Hemofiltration in both settings has a tendency to drain away these upregulated tissue stores which could result in the limited secretory capacity of the peptide.
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http://dx.doi.org/10.33549/physiolres.932051 | DOI Listing |
J Crit Care
January 2025
AP-HP, Hôpital Louis Mourier, DMU ESPRIT, Service de Médecine Intensive Réanimation, F-92700 Colombes, France; Université Paris Cité, Medical school, F-75018 Paris, France; Université Paris Cité, INSERM UMR-S1151, CNRS UMR-S8253, Institut Necker Enfants Malades, F-75015 Paris, France. Electronic address:
The optimal modalities of kidney replacement therapy (KRT) in the ICU remain debated. Intermittent haemodialysis (IHD) and continuous veno-venous haemofiltration (CVVH) are the two main methods. Intermittent haemodialysis requires a water treatment system, which may not be available in all jurisdictions.
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January 2025
Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany.
Background: Results from the CONVINCE clinical trial suggest a 23% mortality risk reduction among patients receiving high-volume (> 23 L) hemodiafiltration. We assessed the real-world effectiveness of blood-based kidney replacement therapy (KRT) with hemodiafiltration vs. hemodialysis in a large, unselected patient population treated prior to and during the COVID-19 pandemic.
View Article and Find Full Text PDFArtif Organs
December 2024
TDA Research, Inc., Wheat Ridge, Colorado, USA.
Background: Hyperkalemia, the buildup of serum potassium to levels >6 mEq L, has been a recognized complication of combat injuries such as acute kidney injury since World War II. Currently, renal replacement therapy (RRT) serves as the standard of care for hyperkalemic patients who fail to respond to medical management. However, RRT is difficult to administer in combat settings, and the time between evacuation and RRT is critical in preventing post-traumatic hyperkalemia.
View Article and Find Full Text PDFInt J Artif Organs
December 2024
Global Systems Engineering, VS Machines, Care Enablement, Fresenius Medical Care Deutschland GmbH, Schweinfurt, Bavaria, Germany.
Clinical studies have shown that hemodiafiltration reduces morbidity and mortality of dialysis patients compared to hemodialysis alone. This is attributed to its superior middle molecule clearance compared to standard hemodialysis. However, doubts arose as to whether a high convective flux through the dialyzer membrane has an influence on the equilibrium concentration of small ions, especially that of sodium.
View Article and Find Full Text PDFAdv Exp Med Biol
October 2024
Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan.
Acute liver failure (ALF) is a disease associated with severe symptoms, including rapid deterioration of liver function and impaired consciousness. Recently, online hemodiafiltration (OLHDF), an artificial liver replacement therapy, has attracted attention as a treatment option for comatose ALF. In this study, changes over time in blood aromatic amino acids (AAAs) and ammonia (NH), the causative agents of hepatic coma, during OLHDF in patients with ALF were analysed.
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