Pulmonary function after modified venovenous ultrafiltration in infants: a prospective, randomized trial.
OBJECTIVE
We sought to examine the effects of modified venovenous ultrafiltration after cardiopulmonary bypass on pulmonary compliance in infants.


METHODS
We prospectively enrolled 38 infants undergoing their first operation for congenital heart disease. Infants were randomized to receive 20 minutes of modified ultrafiltration after bypass or control. Static and dynamic compliance was measured after induction of anesthesia, before and immediately after filtration in the operating theater, 1 hour after return to the pediatric intensive care unit, and 24 hours after the operation. Length of time on the ventilator, inotropic requirements, and length of stay in the intensive care unit were recorded.


RESULTS
Modified ultrafiltration produced a significant immediate improvement in dynamic (pre-ultrafiltration 2.5 +/- 1.9 mL/cm H(2)O to post-ultrafiltration 2.9 +/- 2.7 mL/cm H(2)O, P =.03) and static (pre-ultrafiltration 2.1 +/- 0.9 mL/cm H(2)O to post-ultrafiltration 2.9 +/- 2.1 mL/cm H(2)O, P =.04) compliance. However, there was no significant difference in the change in dynamic (P =.3) or static (P =.7) compliance in the ultrafiltration and control groups when compared before the operation, after the operation, and at 24 hours. There was no significant difference in the time to extubation between patients and control subjects (140 +/- 91 hours vs 90 +/- 58 hours) or the length of intensive care unit stay (10.0 +/- 9.1 days vs 7.4 +/- 5.7 days).


CONCLUSIONS
Modified ultrafiltration produces an improvement in pulmonary compliance after bypass in infants. However, these improvements are not sustained past the immediate post-ultrafiltration period and do not lead to a decreased length of intubation or intensive care unit stay.
Keenan
H T
HT
Department of Pediatrics, Division of Critical Care, University of North Carolina, Chapel Hill, NC 27599-7200, USA. hkeenan@med.unc.edu
Thiagarajan
R
R
Stephens
K E
KE
Williams
G
G
Ramamoorthy
C
C
Lupinetti
F M
FM
D002315:Cardiopulmonary Bypass; D006330:Heart Defects, Congenital / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008170:Lung Compliance / Q000502:physiology*; D011446:Prospective Studies