Intraoperative hemofiltration in adults: prevention of hypercirculatory syndrome?
Hypercirculatory syndrome (HCS) after cardiac surgery may be a sequela of extracorporeal circulation due to hemodilution and release of inflammatory mediators. The aim of this study was to investigate the influence of intraoperative hemofiltration (HF) on the incidence of HCS. A prospective cohort study of 80 patients scheduled for elective coronary bypass was performed. The patients were randomized to two groups: in the conventional (CONV) group 40 patients were treated conventionally and in the HF group 40 patients underwent intraoperative HF. There was no perioperative mortality. The incidence of HCS was comparable in both groups (32% in CONV group versus 40% in HF group; n.s.). Mean cardiac output was higher and systemic vascular resistance lower in CONV group patients than in HF group patients, however these differences did not reach statistical significance. According to this data intraoperative HF does not prevent postoperative HCS induced by cardiopulmonary bypass. Further studies are required to identify the etiology of HCS, and to prevent it occurring after open-heart surgery.
Tirilomis
Theodor
T
Department of Thoracic, Cardiac and Vascular Surgery, University of Göttingen. Robert-Koch-Str. 40, Göttingen D-37075, Germany. theodor.tirilomis@med.uni-goettingen.de
Friedrich
Martin
M
Sîrbu
Horia
H
Aleksic
Ivan
I
Busch
Thomas
T
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D013577:Syndrome