A novel leucocyte-depleting filter for use in continuous venovenous haemofiltration: preliminary in vitro studies

Abstract

Multiple organ failure (MOF) secondary to circulatory shock, sepsis, or trauma was first described over 20 years ago. Despite much research effort and clinical trials of biological response modifiers, MOF continues to be the leading cause of death in both medical and surgical intensive care units (ICU). MOF is associated with widespread cellular and humoral systemic inflammatory responses which, in turn, are linked with inadequate tissue perfusion to vital organs and the inappropriate accumulation of activated neutrophils, resulting in microcirculatory injury. Much evidence suggests that such activated neutrophils cause vascular damage by adhering to the endothelium and releasing a variety of highly reactive and toxic moieties; these may subsequently produce endothelial injury and compromised organ function. We reasoned that a clinical device designed to remove such cells in a controlled fashion from the circulation of patients with MOF by means of using a continuous venovenous circuit might be beneficial. We report the leucocyte depletion performance of a novel filter medium as a first step towards the production of a clinical device, and show specific depletion of phagocytes relative to other formed elements in the blood.