The effect of modified ultrafiltration on the amount of circulating endotoxins in children undergoing cardiopulmonary bypass.
OBJECTIVE
To determine whether the use of modified ultrafiltration during pediatric cardiopulmonary bypass (CPB) diminishes the load of circulating endotoxins.


METHODS
Single-arm prospective observational study.


METHODS
A university hospital operating room and intensive care unit.


METHODS
Twenty children undergoing CPB for correction of various congenital heart diseases.


METHODS
The amount of endotoxins in plasma was measured during CPB and before and after modified ultrafiltration. The ultrafiltrate was assayed for the presence of endotoxins. Postoperatively, the children were followed with relevant infectious parameters and cultures.


RESULTS
The amount of endotoxins increased significantly during the CPB procedure (from a median of 1.3 ng [range, 0 to 13.7 ng] to 24.2 ng [range, 2.1 to 75.9 ng]). After termination of CPB, modified ultrafiltration was shown to lower the amount of circulating endotoxins in blood (from a median of 24.2 ng [range, 2.1 to 75.4 ng] to 9.0 [range, 0.1 to 40.6 ng]). The major bulk of this reduction in endotoxin load was retrieved in the ultrafiltrate (median of 11.9 ng [range, 0 to 12.1 ng]).


CONCLUSIONS
This study strongly suggests that modified ultrafiltration decreases the amount of circulating endotoxins in children undergoing cardiac surgery.
Yndgaard
S
S
Department of Cardiothoracic Anesthesia and Cardiac Surgery, The Heart Center, University of Copenhagen, Rigshospitalet, Denmark.
Andersen
L W
LW
Andersen
C
C
Petterson
G
G
Baek
L
L
D002315:Cardiopulmonary Bypass; D004731:Endotoxins / Q000097:blood*; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D007223:Infant; D011446:Prospective Studies
D004731:Endotoxins