High volume continuous venovenous haemofiltration (HV-CVVH) in an equine endotoxaemic shock model.

This study investigates the potential of a therapy called high volume continuous venovenous haemofiltration (HV-CVVH) to manage shock in horses suffering from acute abdominal disease which can be caused by an influx of endotoxins from the gut. The results reveal that this method does not significantly reduce the symptom indicators of the disease or the level of cytokines in the blood, despite the observed ability of the therapy to clear cytokines from the blood over time. Further research is suggested to identify any potential benefit of this therapy in more severe cases of the disease or with different types of filters.

Research Goals

• This research evaluated the viability of high volume continuous venovenous haemofiltration (HV-CVVH) as a treatment for shock in horses suffering from acute abdominal disease.
• The team aimed to determine whether HV-CVVH could effectively clear endotoxins and cytokines from the bloodstream, which might ameliorate the symptoms of the disease.

Methods

• For this experiment, 10 male Shetland ponies were subjected to a slow infusion of LPS (a type of endotoxin) while under general anaesthesia.
• Half of the ponies were treated with HV-CVVH using a 75 kD polymethylmethacrylate (PMMA filter).
• Over a 6-hour period, the team took measurements of blood variables, haemodynamic values, and cytokine levels every 30 minutes.

Results and Conclusion

• The results of the experiment showed that the ponies reacted as expected to the introduction of LPS into their system, implying that this created a valid model of equine acute abdominal disease.
• However, no significant difference was observed between ponies that received the HV-CVVH treatment and those that did not. This includes parameters such as arterial pressure, blood chemistry, and haematological markers.
• The ponies did exhibit an increase in the clearance of cytokines from the blood over time, but this did not translate into a significant decrease in serum levels of these immune system molecules.
• The study concludes that HV-CVVH did not demonstrate a significant positive effect on the course of experimental endotoxaemia in horses when used with a 75 kD PMMA filter. However, the authors suggest that more severe disease models and different types of filters might show differing results, and so further research might be warranted.