title: Conventional hemofiltration during cardiopulmonary bypass increases the serum lactate level in adult cardiac surgery.
abstract: OBJECTIVE
  To evaluate the effect of hemofiltration during cardiopulmonary bypass on lactate level in adult patients who underwent cardiac surgery.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  Prince Sultan cardiac center, Riyadh, Saudi Arabia.
  
  
  METHODS
  The study included 283 patients classified into two groups: Hemofiltration group (n=138), hemofiltration was done during CPB. Control group (n = 145), patients without hemofiltration.
  
  
  METHODS
  Hemofiltration during cardiopulmonary bypass.
  
  
  RESULTS
  Monitors included hematocrit, lactate levels, mixed venous oxygen saturation, amount of fluid removal during hemofiltration and urine output. The lactate elevated in group H than group C (P < 0.05), and the PH showed metabolic acidosis in group H (P < 0.05). The mixed venous oxygen saturation decreased in group H than group C (P < 0.05). The number of transfused packed red blood cells was lower in group H than group C (P < 0.05). The hematocrit was higher in group H than group C (P < 0.05). The urine output was lower in group H than group C (P < 0.05).
  
  
  CONCLUSIONS
  Hemofiltration during cardiopulmonary bypass leads to hemoconcentration, elevated lactate level and increased inotropic support. There are some recommendations for hemofiltration: First; Hemofiltration should be limited for patients with impaired renal function, positive fluid balance, reduced response to diuretics or prolonged bypass time more than 2 hours. Second; Minimal amount of fluids should be administered to maintain adequate cardiac output and reduction of priming volumes is preferable to maintain controlled hemodilution. Third; it should be done before weaning of or after cardiopulmonary bypass and not during the whole time of cardiopulmonary bypass.
authors.affiliation: Department of Cardiac anesthesia, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia; Department of Anesthesia, Cairo University, Giza, Egypt.
authors.forename: Rabie
authors.initials: R
authors.lastname: Soliman
authors.forename: Eman
authors.initials: E
authors.lastname: Fouad
authors.forename: Makhlouf
authors.initials: M
authors.lastname: Belghith
authors.forename: Tarek
authors.initials: T
authors.lastname: Abdelmageed
mesh_terms: D000138:Acidosis / Q000209:etiology; D000368:Aged; D002302:Cardiac Output; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D004232:Diuretics / Q000627:therapeutic use; D017707:Erythrocyte Transfusion; D005260:Female; D006400:Hematocrit; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D014563:Urodynamics; D014882:Water-Electrolyte Balance
chemical_list: D004232:Diuretics; D019344:Lactic Acid; D010100:Oxygen