Effects of Modified Ultrafiltration in Pediatric Open Heart Surgery.
- Author:
Tae Gook JUN
1
;
Pyo Won PARK
;
Yong Soo CHOI
;
Chung Su KIM
;
Yang Koo YUN
;
Wook Sung KIM
;
Kay Hyun PARK
;
Kwhan Mien KIM
;
Jhin Gook KIM
;
Young Mog SHIM
;
Hurn CHAE
Author Information
1. Department of Thoracic and Cardiovasular Surgery, Samsung Medical Center, Korea.
- Publication Type:Original Article
- Keywords:
filtration;
cardiopulmonary bypass;
hemodynamics
- MeSH:
Body Water;
Capillaries;
Cardiopulmonary Bypass;
Child;
Diagnosis;
Filtration;
Heart*;
Hemodynamics;
Humans;
Mechanics;
Thoracic Surgery*;
Ultrafiltration*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1997;30(6):591-597
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cardiopulmonary bypass in children is associated with capillary leak, which results in an increase in total body water after open heart surgery. The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery. Study A: Twenty-six consecutive children aged 0.1~10 years(median 7 months) underwent cardiac operation incorporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~150l/min for 3~14 min. After modified ultrafiltration, elevation of hematocrit(28.3%+/-3.6% vs. 33.8%+/-4.0%, p<0.001), increased systolic blood pressure(66.7+/-11.2mmHg vs. 76.2+/-11.8mmHg, p<0.02), and decreased central venous pressure(7.8+/-3.7mmHg vs. 6.9+/-2.9mmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n=14) or modified ultrafiltration(n=12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0+/-2.4 cmH2O vs. 22.4+/-2.3cmH2O, p< 0.03). Modified ultrafiltration after cardiopulmonary bypass in children improves early hemo- dynamics and pulmonary mechanics, and represents an excellent option for perioperative management of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.
