title: Modified ultrafiltration reduces postoperative morbidity after cavopulmonary connection.
abstract: BACKGROUND
  Modified ultrafiltration reduces the deleterious effects of cardiopulmonary bypass in children. Patients undergoing repair of single-ventricle cardiac anomalies may be particularly sensitive to these adverse effects, and benefit from the use of modified ultrafiltration.
  
  
  METHODS
  From January 1995 to June 1996, 120 consecutive cavopulmonary operations were performed at The Children's Hospital of Philadelphia. Procedures included lateral tunnel fenestrated Fontan (n = 50), extracardiac Fontan (n = 5), hemi-Fontan (n = 60), and bidirectional Glenn shunt (n = 5). Modified ultrafiltration was performed after cardiopulmonary bypass in 41 patients, and results were compared by t test with a control group of 79 patients in whom modified ultrafiltration was not used.
  
  
  RESULTS
  There was one death for an operative (30-day) mortality of 0.8%. Age, weight, diagnosis, ischemic arrest time, and cardiopulmonary bypass time were similar between the modified ultrafiltration and control groups. Postoperative blood use, chest tube output, the incidence of pleural and pericardial effusions, and hospital stay were all significantly decreased when modified ultrafiltration was used.
  
  
  CONCLUSIONS
  By lowering the perioperative morbidity of staged cavopulmonary operations, modified ultrafiltration makes an important contribution to improving outcome after the correction of single-ventricle cardiac anomalies.
authors.affiliation: Department of Anesthesiology, Children's Hospital of Philadelphia, PA 19104, USA.
authors.forename: T C
authors.initials: TC
authors.lastname: Koutlas
authors.forename: J W
authors.initials: JW
authors.lastname: Gaynor
authors.forename: S C
authors.initials: SC
authors.lastname: Nicolson
authors.forename: J M
authors.initials: JM
authors.lastname: Steven
authors.forename: G
authors.initials: G
authors.lastname: Wernovsky
authors.forename: T L
authors.initials: TL
authors.lastname: Spray
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D018729:Fontan Procedure; D006324:Heart Arrest, Induced; D018610:Heart Bypass, Right; D006330:Heart Defects, Congenital / Q000601:surgery*; D006400:Hematocrit; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007223:Infant; D009017:Morbidity; D011183:Postoperative Complications / Q000517:prevention & control*; D016896:Treatment Outcome