Impact of CVVH on monocyte activation in the critically ill

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Introduction

Monocyte activation (HLA-DR⁺ CD14⁺) was suggested to be a useful marker of immune system function. As extracorporeal circuit might influence the immune response (e.g. bioincompatibility and/or elimination of pro/anti-inflammatory cytokines) we investigated the impact of CVVH initiation on monocyte activation in critically ill patients.

Methods

Fifteen septic (4 ICU survivors) and 7 nonseptic (1 ICU survivor) critically ill patients in whom CVVH (ultra-filtration 1–2 l h^-1) was initiated because of acute renal failure as a part of MODS. Expression of HLA-DR⁺ CD14⁺ was assessed by flow-cytometry before CVVH initiation and at 4 h and 24 h afterwards. The Friedmann two-way ANOVA and Mann-Whitney U tests were used when appropriate. Data are presented as means ± SD; P<0.05 was considered significant.

Results

Baseline HLA-DR⁺CD14⁺ values in septic and non-septic patients were not different (57± 21% and 71± 21% respectively, P=0.23). Time course of HLA-DR⁺CD14⁺ during the first 24h of CVVH are shown in Fig. 1.

Conclusion

CVVH initiation has no impact on monocyte HLA-DR expression in both septic and nonseptic patients.

Figure 1