Tumor necrosis factor and interleukin 1 appearance in experimental gram-negative septic shock. The effects of plasma exchange with albumin and plasma infusion
R. Busund, R. O. Lindsetmo, L. T. Rasmussen, O. Rokke, O. P. Rekvig and A. Revhaug
Department of Surgery, Tromso University Hospital, Norway.
To study the effect of plasma removal vs plasma administration on the
appearance of tumor necrosis factor (TNF) and interleukin 1 in septic
shock, 24 anesthetized piglets were inoculated with live Escherichia coli.
Plasma exchange with albumin was performed in one group. Fresh-frozen
plasma was administered to a second group. A third group served as
nontreated controls. Following plasma exchange, a reduction in both TNF and
interleukin 1 levels occurred, whereas plasma infusion was followed by a
decrease in TNF levels only. No significant differences were observed
between the two treated groups with respect to survival or cardiovascular
performance, with both being significantly enhanced compared with the
controls. High levels of TNF and interleukin 1 correlated with depressed
cardiovascular performance in the early phase of the shock. Our results
confirm the important role of TNF and interleukin 1 as early mediators of
septic shock. However, the benefit of reducing cytokine activity in later
stages of septicemia seems to be dubious.
