1Department of Cardiopulmonary bypass, Beijing Anzhen Hospital, Capital Medical University
Department of Cardiopulmonary Bypass, State key laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Disease
Online published on 7 August, 2012.
Ultrafiltration (UF) has been widely accepted clinically in pediatric patients. However, the optimal strategy of UF during pediatric Cardiopulmonary bypass (CPB) is still under debate. The purpose of this investigation was to compare the clinical effects of three UF strategies used during pediatric CPB.
One hundred and ninety-six pediatric patients whose weights were below 8 kilograms underwent heart surgery with CPB between January 2009 and July 2010. We divided the infants into three groups randomly: conventional ultrafiltration (CUF) (C Group), arteriovenous modified ultrafiltration (MUF) (M Group) and combined CUF, Zero-balanced ultrafiltration (Z-BUF) with MUF (Z Group).
We recorded and compared clinical outcomes of the three groups and also focused on the volume of donor blood transfusion and the level of lactate and blood glucose before, during and after the operation. There were no significant differences between the three groups in pre-operative data. After surgery, the hematocrit level of C group was lower than the other two groups (p<0.05); lactic acid and blood glucose levels in Z group were lower than C group (p<0.05); the volume of blood transfusion in C group was higher than M group and Z group (p<0.05).
There was clinical advantage in combining CUF, Z-BUF with MUF, since this ultrafiltration strategy could reduce transfusion, decrease the level of lactic acid and maintain suitable blood glucose level during CPB, promoting early post-operative recovery in pediatric patients.
Infant, Cardiopulmonary bypass, ultrafiltration, lactate, blood glucose
