Effects of modified ultrafiltration on coagulation factors in pediatric cardiac surgery.
OBJECTIVE
Modified ultrafiltration (MUF) after cardiopulmonary bypass (CPB) in children has been reported to reduce the need for postoperative blood transfusion and minimize postoperative blood loss. This study was undertaken to quantify the effects of MUF on coagulation factors in pediatric patients.


METHODS
Seven children scheduled to undergo open-heart surgery for congenital heart defects were studied. CPB circuits were primed with crystalloid solutions and no blood transfusions were performed. Hematocrit, platelet count, total plasma proteins, albumin, fibrinogen, prothrombin, factor VII, factor IX, and factor X were measured preoperatively, at the termination of cardiopulmonary bypass, and at the end of modified ultrafiltration.


RESULTS
MUF was associated with significant (P < 0.05) increases in hematocrit (17.6% +/- 1.6% to 21.6% +/- 2.4%), platelet count 11.1 +/- 2.5 to 12.8 +/- 2.4 x 10(4)/mm3), total plasma proteins (2.7 +/- 0.3 to 3.4 +/- 0.4 g/dl), and albumin (1.6 +/- 0.2 to 2.1 +/- 0.2 g/dl). Fibrinogen, prothrombin, and factor VII also increased significantly (P < 0.05) during MUF, but factor IX and factor X did not change.


CONCLUSIONS
We conclude that MUF attenuates the dilutional coagulopathy that occurs during CPB in children. There were slight improvements in the coagulation factors when MUF was employed.
Ootaki
Yoshio
Y
Department of Cardiothoracic Surgery, Kobe Children's Hospital, Hyogo, Japan.
Yamaguchi
Masahiro
M
Oshima
Yoshihiro
Y
Yoshimura
Naoki
N
Oka
Shigeteru
S
D001779:Blood Coagulation Factors / Q000032:analysis*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000601:surgery; D006400:Hematocrit; D006440:Hemofiltration / Q000379:methods*; D006801:Humans
D001779:Blood Coagulation Factors