[Efficiency of the preliminary and continuous hemodialysis at open heart surgery in infants and children].
To eliminate the cytokines and leukocytes-induced proteases which could cause the multisystem organ failure postoperatively, we performed a preliminary hemodialysis to the priming solution and a continuous hemodialysis during extracorporeal circulation (ECC) in 5 children (HD group), and neither hemodialysis in another 5 children (Control group). We measured the plasma level of Interleukin-1 (IL-1), Interleukin-6 (IL-6) and leukocyte elastase (Ease) to evaluate the efficiency of these hemodialysis. Urine level of alpha 1-microglobulin (MG), beta 2-MG, urine volume, water balance and perfusion pressures during ECC were also measured to evaluate its protective effect for the renal function. IL-1 level significantly decreased in HD group 1 and 12 hours after operation. Not only IL-6 and Ease during ECC but also alpha 1- and beta 2-MG 1 hour after operation decreased in HD group so hemodialysis could be useful to eliminate the cytokines. Ease and could protect the renal function. Water balance and perfusion pressures also obtained good results with these hemodialysis. Plasma osmolality and glucose level changed within the normal range in HD group, conversely over the normal range in control group. We conclude this method is useful for neonatal, ECC.
Nomura
K
K
Department of Cardiovascular Surgery, Saitama Children's Medical Center, Japan.
Yamagishi
M
M
Nakamura
Y
Y
D006348:Cardiac Surgical Procedures / Q000379:methods; D002675:Child, Preschool; D005112:Extracorporeal Circulation; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D009994:Osmolar Concentration; D006435:Renal Dialysis / Q000592:standards*