title: The effects of modified ultrafiltration on pulmonary function and transfusion requirements in patients underwent coronary artery bypass graft surgery.
abstract: OBJECTIVE
  The inflammatory response after cardiac surgery increases vascular permeability leading to higher mortality and morbidity in the post operative time. The modified ultrafiltration (MUF) had shown benefits on respiratory, and hemodynamic in pediatric patients. This approach in adults is not well established yet. We hypothesize that modified ultrafiltration may improve respiratory, hemodynamic and coagulation function in adults after cardiac surgeries.
  
  
  METHODS
  A prospective randomized study was carried out with 37 patients who underwent coronary artery bypass graft surgery (CABG) were randomized either to MUF (n=20) at the end of bypass or to control (no MUF) (n=17). The anesthesia and ICU team were blinded for the group selection. The MUF were carried out for 15 minutes after the end of bypass. The patients data were taken at beginning of anesthesia, ending of bypass, ending MUF, 24 hours, and 48 hours after surgery. For clinical outcome the pulmonary, hemodynamic and coagulation function were evaluated.
  
  
  RESULTS
  We observed lower drain loss in the MUF group compared to control group after 48 hours (598 +/- 123 ml vs. 848 +/- 455 ml; P=0.04) and required less red blood cells units transfusion compared to control group (0.6 +/- 0.6 units/patient vs.1.6 +/- 1.1 units/patient; P=0.03). The MUF group showed lower airway resistance (9.3 +/- 0.4 cmH2O.L-1s-1 vs. 12.1 +/- 0.8 cmH2O.L-1s-1; P=0.04). There were no deaths in both groups.
  
  
  CONCLUSIONS
  The MUF reduces post operatory bleeding and red blood cells units transfusion, but with no differences on clinical outcome were observed. The routinely MUF employment was not associated with hemodynamic instability.
authors.affiliation: Surgery Department - Heart Surgery Division - Faculdade de Ciências-Médicas Universidade Estadual de Campinas - UNICAMP.
authors.forename: Anali Galluce
authors.initials: AG
authors.lastname: Torina
authors.forename: Orlando
authors.initials: O
authors.lastname: Petrucci
authors.forename: Pedro Paulo Martins de
authors.initials: PP
authors.lastname: Oliveira
authors.forename: Elaine Soraya Barbosa de Oliveira
authors.initials: ES
authors.lastname: Severino
authors.forename: Karlos Alexandre de Souza
authors.initials: KA
authors.lastname: Vilarinho
authors.forename: Carlos Fernando Ramos
authors.initials: CF
authors.lastname: Lavagnoli
authors.forename: Maria Heloisa
authors.initials: MH
authors.lastname: Blotta
authors.forename: Reinaldo Wilson
authors.initials: RW
authors.lastname: Vieira
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001777:Blood Coagulation / Q000502:physiology*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006440:Hemofiltration / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D015656:Respiratory Mechanics / Q000502:physiology*