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The Effects of Plasma Exchange With Albumin and Plasma Infusion

Rolf Busund, MD; Rolv-Ole Lindsetmo, MD; Lill-Tove Rasmussen, MD; Ola Røkke, MD; Ole P. Rekvig, MD; Arthur Revhaug, MD

Arch Surg. 1991;126(5):591-597.

Abstract
• 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.

(Arch Surg. 1991;126:591-597)

Author Affiliations
From the Departments of Surgery (Drs Busund, Lindsetmo, Røkke, and Revhaug) and Immunology (Dr Rekvig), Tromsö (Norway) University Hospital, and the Institute of Medical Biology, University of Trömso (Dr Rasmussen).

Footnotes
Accepted for publication July 22, 1990.

Presented in part at the symposium of "The Immunocompromised Surgical Patient: Mechanisms and Therapy in Trauma and Burns," Snowbird, Utah, January 27, 1990.

Reprint requests to Department of Surgery, Tromsö University Hospital, 9012 Tromsö, Norway (Dr Busund).

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