• Martin Sauer, Jens Altrichter, Hans J Kreutzer, Tim Lögters, Martin Scholz, Gabriele Nöldge-Schomburg, Reinhard Schmidt, and Steffen R Mitzner.
• Department of Anesthesiology and Intensive Care Medicine, Medical Faculty of the University of Rostock, Rostock, Germany.
• Crit. Care Med. 2009 Feb 1;37(2):606-13.

ObjectivesGranulocyte transfusions have been used to treat immune cell dysfunction in sepsis. As granulocyte transfusions can trigger tissue injury via local effects of neutrophils, we hypothesized that extracorporeal treatment of plasma using granulocytes would prove beneficial while having less side effects.DesignProspective controlled three-armed animal study.SettingResearch laboratory.SubjectsTwenty-one female immature pigs (7.5-12 kg, 7-9 weeks old).InterventionsThree groups of spontaneously breathing, sedated pigs (n = 7 each) received an intravenous lethal dose of live Staphylococcus aureus over 1 hour. Although group I had no specific treatment (control), group II and III were subsequently treated for 4 hours with an extracorporeal device containing either no cells (sham control, group II) or human cell line-derived granulocytic cells (group III). Survival time and physiologic, biochemical, and hematologic parameters were monitored for 7 days.Measurements And Main ResultsAll animals of group I died during the observation time (mean survival time: 70 hours). In group II, two of seven and in group III, six of seven animals survived the observation time (mean survival: 75 and 168 hours, respectively). Survival differences were significant between group I and III (p < 0.001) and between group II and III (p < 0.05) but not between group I and II (p = 0.43). Furthermore, group differences in bacterial blood concentrations, differential blood count, blood gases, lactate, and interleukins were observed. The extracorporeal cell treatment was well tolerated by the animals.ConclusionsExtracorporeal therapy with granulocytic cells significantly improved survival in a pig model of sepsis. Further studies with this approach are encouraged.

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