Effect of flow rate, negative pressure, and duration of modified ultrafiltration on hemodynamics and inflammatory mediators.
The objective of this study was to evaluate the effect of flow rate, negative pressure, and duration on modified ultrafiltration (MUF). Eighty children weighing less than 10 kg with congenital heart disease were randomly divided into four groups: group C (conventional MUF); group H (high flow rate MUF); group P (high negative pressure MUF); and group L (long duration, high flow rate MUF). The changes in body weight, hematocrit, and hemodynamics were recorded. Tumor necrosis factor and interleukin-6 were measured before bypass, bypass stop, and MUF cessation. The durations of MUF in groups H and P were significantly shorter than in the other two groups; the volume filtered in group L was much greater than in the other three groups. The changes of bodyweight, heart rate, blood pressure, and hematocrit were similar in all groups. The increased extent of inflammatory mediators was a little lower in group L. Modified ultrafiltration can reverse hemodilution and improve cardiac function even with high flow rate or negative pressure. Prolonging the duration of MUF can filter out more inflammatory mediators, but the increased trend cannot be reversed in 15 minutes.
Wang
Wei
W
Department of Pediatric Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Zhu
De-ming
DM
Huang
Hui-min
HM
Cai
Xiao-man
XM
Xu
Chong
C
Jlang
Li-min
LM
Shen
Li-song
LS
D001794:Blood Pressure; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006339:Heart Rate; D006400:Hematocrit; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014462:Ultrafiltration / Q000379:methods*
D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha