A Circulating Myocardial Depressant Substance is Associated with Cardiac Dysfunction and Peripheral Hypoperfusion: Ultrafiltration Experiments

In: Septic Shock

3 Nov 2014

A Circulating Myocardial Depressant Substance is Associated with Cardiac Dysfunction and Peripheral Hypoperfusion: Ultrafiltration ExperimentsUltrafiltration Experiments
Sera from selected critically ill, nonseptic patients, septic patients with and without MDS activity, and normal human volunteers were passed through Amicon filters (Amicon Corp), which allows passage of molecules with weights below 10,000 daltons (Amicon PM 10) or below 30,000 daltons (Amicon PM30). Assays were performed on both the filtrates and the supernatants. The characteristics of the myocardial cells and the definition of a positive MDS assay used for these serum fractions were identical to those used for whole sera.

Statistics
Comparisons between patient groups were performed using paired or unpaired Students t tests, as appropriate. Where appropriate, results were also analyzed using nonparametric Wilcoxon rank-sum test (Mann-Whitney). Spearman rank coefficients were calculated to evaluate the relationships between different independent variables. For categorical variables, groups were compared by x* analysis. A p value of <0.05 was regarded as statistically significant. Source

Results
Patient Characteristics and Classification
Fifty patients with a mean age of 49 years (range, 13 to 71) were analyzed in this study. Thirty-four of these 50 patients had definite septic shock, and 16 were critically ill but not septic. One of these 16 nonseptic patients had severe cardiogenic shock (LVEF of 5 percent) and had a positive assay for MDS; the other 15 had negative assays. Since the study protocol was designed to compare septic shock patients with and without myocardial depressant activity, these 16 nonseptic patients were not included when comparing MDS positive vs MDS negative patients.
The 34 septic shock patients had a mean age of 48 years (range, 13 to 70). Eighteen of the patients were males and 16 were females. Seventeen of these patients had leukemia or lymphoma, 12 had solid tumors, two had acquired immunodeficiency syndrome, one had hepatitis, one had ataxia-telangiectasia, and one had aplastic anemia.


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