Comparetive study of conventional vs. zero-balanced ultrafiltration in concentration of serum pro-inflammatory factors and incidence of acute kidney injury after cardio-pulmonary bypass proce-dures
10.3969/j.issn.1005-6483.2015.03.018
- VernacularTitle:常规超滤与零平衡超滤对体外循环术后促炎症因子浓度及急性肾损伤关系的影响
- Author:
Zhimin YANG
;
Zhiwei WANG
;
Zhipeng HU
- Publication Type:Journal Article
- Keywords:
cardio-pulmonary bypass;
ultrafiltration;
cytokines;
acute kidney injur
- From:
Journal of Clinical Surgery
2015;(3):206-209
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the impact of conventional vs. zero-balanced ultrafiltration on serum pro-inflammatory factors,acute kidney injury and clinical prognosis after cardio-pulmonary bypass procedure. Methods Forty patients receiving cardiac surgery under cardio-pulmonary bypass procedures in Xiangyang Central Hospital during January 2013 to June 2013 were randomly divided into conventional ultrafiltration group(group A,n=20)and zero-balanced ultrafiltration group(group B,n=20). Blood and urine samples were collected on different time points( pre-operation,T0;pre-ultrafiltration,T1;immediately after ultrafiltration,T2;24 hours post-operation,T3;48 hours post-operation,T4;7 days post-operation, T5). TNF-α,IL-6,KIM-1,CysC,serum creatinine and urea nitrogen were detected and compared. Pre-and post-operative clinical data were also collected. Results There was no difference in baseline data or intra-operative data(p>0. 05). TNF-αand IL-6 started to increase when the operation began. Compared with conventional ultrafiltration,zero-balanced ultrafiltration alleviated the increase of TNF-α and IL-6,espe-cially on T2,T3,and T4(p<0. 05). Zero-balanced ultrafiltration also decreased CysC,Rbp,serum creati-nine and urea nitrogen on T2,T3,and T4 compared with conventional ultrafiltration(p<0. 05). A total of 11 patients experienced AKI( >grade I)in group A and 2 patients experienced in group B(p<0. 01). There were significant differences of ventilation time,total complication incidence and ICU stay time be-tween two groups. There was no difference in other complications,post-operative days in hospital or death rate within 30 days. Conclusion Though there is a trend of more patients receving renal replacement therapy,no statistical difference has been achieved. In conclusion,zero-balanced ultrafiltration can effec-tively decrease the concentration of serum pro-inflammatory factors,alleviate acute kidney injury and improve the clinical prognosis after cardio-pulmonary bypass procedures. It is a safe and reliable method valuable for promotion.
