Efficacy of modified ultrafiltration combined with conventional ultrafiltration for cardiac valve replacement in patients with severe valve disease
10.3760/cma.j.issn.0254-1416.2012.06.003
- VernacularTitle:改良超滤联合常规超滤用于重症心脏瓣膜病患者瓣膜置换术的效果
- Author:
Conghu YUAN
;
Lin JI
;
Yajun ZHANG
- Publication Type:Journal Article
- Keywords:
Rheumatic heart disease;
Heart valve prosthesis implantation;
Cardiopulmonary bypass;
Ultrafiltration
- From:
Chinese Journal of Anesthesiology
2012;32(6):661-664
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the efficacy of modified ultrafiltration (MUF) combined with conventional ultrafiltration (CUF) for cardiac valve replacement in patients with severe valve disease.MethodsOne hundred and eight NYHA Ⅲ or Ⅳ patients with severe valve disease,aged≥ 18 yr,weighing 50-80 kg,scheduled for elective cardiac valve replacement under cardiopulmonary bypass (CPB) were randomized into CUF group ( n =56) and CUF combined with MUF group (CMUF group,n =52).MUF was performed at the end of CPB,and the flow and time was 400 ml/min and 15-20 min respectively.Arterial blood samples were taken for blood gas analysis and for measurement of the plasma IL-6 and IL-8 concentrations after induction of anesthesia (T1),at the beginning of CUF (T2),at the end of GUF (T3),at the beginning of MUF (T4),at the end of MUF (T5),and at 2,8 and 24 h after the termination of CPB (T5-8).The oxygenation index was calculated and the airway pressure was recorded at T5 8.The amount of urine output during operation,the amount of urine output and volume of chest tube drainage within 24 h after operation,extubation time,packed red blood cell (PRBC) transfusion and duration of stay in ICU were recorded.ResultsCompared with CUF group,the hematocrit at T5,6 and oxygenation index at T7,8 were significantly increased,extuhation time was significantly shortened,and the amount of urine output and volume of chest tube drainage within 24 h after operation and PRBC transfusion were significantly reduced ( P ＜0.05),and no significant change was found in the plasma IL-6 and IL-8 concentrations,airway pressurc,amount of urine output during operation,and the duration of stay in ICU in group CMUF ( P ＞ 0.05).ConclusionCombination of MUF and CUF during CPB can be used for cardiac valve replacement in patients with severe valve disease,improve the function of organs after operation and reduce homologous blood transfusion.
