| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Annals of Thoracic Surgery, Vol 56, 1518-1522, Copyright © 1993 by The Society of Thoracic Surgeons
MJ Elliott
The capillary leak associated with cardiopulmonary bypass results in an
increase in content of water in the tissues measurable by an increase in
total body water after cardiac operation. Following work by Magilligan in
the 1970s, ultrafiltration was introduced during bypass as a means of
hemoconcentrating patients and potentially removing water from the tissues.
Conventional methods proved inconsistent; thus, we modified the technique
to ultrafilter the patients immediately after cessation of bypass. Modified
ultrafiltration takes 10 minutes and results in an elevation of the
on-bypass hematocrit to about 35% or 40%. In pilot studies comparing bypass
in absence of ultrafiltration with conventional ultrafiltration and
modified ultrafiltration, only the modified technique was seen reliably to
reduce the elevation in total body water to only 4%, within a narrow range.
Subsequent prospective studies confirmed the reduction in accumulation of
total body water and also demonstrated a reduction in blood loss and in
requirements for blood transfusion. Systolic blood pressure was observed to
increase uniformly in all patients undergoing modified ultrafiltration.
This effect was investigated and found to be associated with a marked
increase in cardiac index, no change in systemic vascular resistance, a
decrease in heart rate, and a marked decrease in pulmonary vascular
resistance. Recently, we have demonstrated an increase in contractility and
a decrease in myocardial wall volume. The modified technique of
ultrafiltration has been employed successfully in more than 400 patients in
our institution, and represents an excellent option for perioperative
management of both accumulation of fluid in the tissues and hemodynamics
after hypothermic bypass.
ARTICLES
Ultrafiltration and modified ultrafiltration in pediatric open heart operations
Hospital for Sick Children, London, England.
This article has been cited by other articles:
|
|
 |
|
  N. Yoshimura, Y. Oshima, M. Yoshida, H. Murakami, H. Matsuhisa, and M. Yamaguchi Continuous Hemodiafiltration During Cardiopulmonary Bypass in Infants Asian Cardiovasc Thorac Ann, October 1, 2007; 15(5): 376 - 380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. D. Williams, C. Ramamoorthy, L. Chu, G. B. Hammer, K. Kamra, M. G. Boltz, K. Pentcheva, J. P. McCarthy, and V. M. Reddy Modified and conventional ultrafiltration during pediatric cardiac surgery: Clinical outcomes compared J. Thorac. Cardiovasc. Surg., December 1, 2006; 132(6): 1291 - 1298. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. M Medlin and J. J Sistino Cerebral oxygen saturation changes during modified ultrafiltration Perfusion, November 1, 2006; 21(6): 325 - 328. [Abstract] [PDF]
|
|
|
|
|
|
S. G Raja, S. Yousufuddin, F. Rasool, A. Nubi, M. Danton, and J. Pollock Impact of modified ultrafiltration on morbidity after pediatric cardiac surgery. Asian Cardiovasc Thorac Ann, August 1, 2006; 14(4): 341 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Karamlou, J. M. Schultz, C. Silliman, C. Sandquist, J. You, I. Shen, and R. M. Ungerleider Using a Miniaturized Circuit and an Asanguineous Prime to Reduce Neutrophil-Mediated Organ Dysfunction Following Infant Cardiopulmonary Bypass Ann. Thorac. Surg., July 1, 2005; 80(1): 6 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Dittrich, D. Aktuerk, S. Seitz, P. Mehwald, J. Schulte-Monting, C. Schlensak, and D. Kececioglu Effects of ultrafiltration and peritoneal dialysis on proinflammatory cytokines during cardiopulmonary bypass surgery in newborns and infants Eur. J. Cardiothorac. Surg., June 1, 2004; 25(6): 935 - 940. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Berdat, E. Eichenberger, J. Ebell, J.-P. Pfammatter, M. Pavlovic, C. Zobrist, E. Gygax, U. Nydegger, and T. Carrel Elimination of proinflammatory cytokines in pediatric cardiac surgery: Analysis of ultrafiltration method and filter type J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1688 - 1696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Jensen, S. Andreasson, A. Bengtsson, H. Berggren, R. Ekroth, L. E. Larsson, and J. Ouchterlony Changes in hemostasis during pediatric heart surgery: impact of a biocompatible heparin-coated perfusion system Ann. Thorac. Surg., March 1, 2004; 77(3): 962 - 967. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Carotti, F. Emma, S. Picca, E. Iannace, S. B. Albanese, M. Grigioni, F. Meo, M. Sciarra, and R. M. Di Donato Inflammatory response to cardiac bypass in ewe fetuses: effects of steroid administration or continuous hemodiafiltration J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1839 - 1848. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Chong, C. R. Hampton, and E. D. Verrier Microvascular Inflammatory Response in Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2003; 7(3): 333 - 354. [Abstract] [PDF]
|
|
|
|
|
|
H. Huang, T. Yao, W. Wang, D. Zhu, W. Zhang, H. Chen, and W. Fu Continuous ultrafiltration attenuates the pulmonary injury that follows open heart surgery with cardiopulmonary bypass Ann. Thorac. Surg., July 1, 2003; 76(1): 136 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Jensen, S. Andreasson, A. Bengtsson, H. Berggren, R. Ekroth, L. Lindholm, and J. Ouchterlony Influence of two different perfusion systems on inflammatory response in pediatric heart surgery Ann. Thorac. Surg., March 1, 2003; 75(3): 919 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Shen, C. Giacomuzzi, and R. M. Ungerleider Current strategies for optimizing the use of cardiopulmonary bypass in neonates and infants Ann. Thorac. Surg., February 1, 2003; 75(2): S729 - 734. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A Maluf Modified ultrafiltration in surgical correction of congenital heart disease with cardiopulmonary bypass Perfusion, January 1, 2003; 18(1_suppl): 61 - 68. [Abstract] [PDF]
|
|
|
|
|
|
R. Bartkowski, M. Wojtalik, E. Korman, G. Sharma, J. Henschke, and W. Mrowczynski Thyroid hormones levels in infants during and after cardiopulmonary bypass with ultrafiltration Eur. J. Cardiothorac. Surg., December 1, 2002; 22(6): 879 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Samir, A. Riberi, O. Ghez, M. Ali, D. Metras, and B. Kreitmann Delayed sternal closure: a life-saving measure in neonatal open heart surgery; could it be predictable? Eur. J. Cardiothorac. Surg., May 1, 2002; 21(5): 787 - 793. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Hiramatsu, Y. Imai, H. Kurosawa, Y. Takanashi, M. Aoki, T. Shin'oka, and M. Nakazawa Effects of dilutional and modified ultrafiltration in plasma endothelin-1 and pulmonary vascular resistance after the Fontan procedure Ann. Thorac. Surg., March 1, 2002; 73(3): 862 - 865. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D Tallman, M. Dumond, and D. Brown Inflammatory mediator removal by zero-balance ultrafiltration during cardiopulmonary bypass Perfusion, March 1, 2002; 17(2): 111 - 115. [Abstract] [PDF]
|
|
|
|
|
|
N. Ad, J. P. Suyderhoud, Y. D. Kim, M. A. Makary, K. W. DeGroot, H. C. Lue, E. A. Pirovic, W. Z. Duvall, and J. L. Cox Benefits of prophylactic continuous infusion of furosemide after the maze procedure for atrial fibrillation J. Thorac. Cardiovasc. Surg., February 1, 2002; 123(2): 232 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. R. Stephenson Jr and J. L. Myers Pediatric cardiopulmonary bypass Ann. Thorac. Surg., December 1, 2001; 72(6): 2176 - 2177. [Full Text] [PDF]
|
|
|
|
|
|
H. A. Hennein Inflammation After Cardiopulmonary Bypass: Therapy for the Postpump Syndrome Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 236 - 255. [Abstract] [PDF]
|
|
|
|
|
|
S. T. Verghese Modified Ultrafiltration in Children Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2001; 5(1): 98 - 104. [Abstract] [PDF]
|
|
|
|
|
|
A Sablotzki, J Muhling, M G Dehne, B Zickmann, R E Silber, and I Friedrich Treatment of sepsis in cardiac surgery: role of immunoglobulins Perfusion, March 1, 2001; 16(2): 113 - 120. [Abstract] [PDF]
|
|
|
|
|
|
R. G. Leyh, C. Bartels, E. Joubert-Hubner, J. F.M. Bechtel, and H. H. Sievers Influence of modified ultrafiltration on coagulation, fibrinolysis and blood loss in adult cardiac surgery Eur. J. Cardiothorac. Surg., February 1, 2001; 19(2): 145 - 151. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Onoe, T. Magara, Y. Yamamoto, and T. Nojima Modified ultrafiltration removes serum interleukin-8 in adult cardiac surgery Perfusion, January 1, 2001; 16(1): 37 - 42. [Abstract] [PDF]
|
|
|
|
|
|
G. J Myers, R. B Leadon, L. B Mitchell, and D. B Ross Simple modified ultrafiltration Perfusion, September 1, 2000; 15(5): 447 - 452. [Abstract] [PDF]
|
|
|
|
|
|
P. M. Bokesch, M. B. Kapural, E. B. Mossad, M. Cavaglia, E. Appachi, J. J. Drummond-Webb, and R. B.B. Mee Do peritoneal catheters remove pro-inflammatory cytokines after cardiopulmonary bypass in neonates? Ann. Thorac. Surg., August 1, 2000; 70(2): 639 - 643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Mosca, T. J. Kulik, C. S. Goldberg, R. P. Vermilion, J. R. Charpie, D. C. Crowley, and E. L. Bove EARLY RESULTS OF THE FONTAN PROCEDURE IN ONE HUNDRED CONSECUTIVE PATIENTS WITH HYPOPLASTIC LEFT HEART SYNDROME J. Thorac. Cardiovasc. Surg., June 1, 2000; 119(6): 1110 - 1118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Codispoti and P. S Mankad Management of anticoagulation and its reversal during paediatric cardiopulmonary bypass: a review of current UK practice Perfusion, May 1, 2000; 15(3): 191 - 201. [Abstract] [PDF]
|
|
|
|
|
|
H. T. Keenan, R. Thiagarajan, K. E. Stephens, G. Williams, C. Ramamoorthy, and F. M. Lupinetti PULMONARY FUNCTION AFTER MODIFIED VENOVENOUS ULTRAFILTRATION IN INFANTS: A PROSPECTIVE, RANDOMIZED TRIAL J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 501 - 505. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Bog'a, F. Islamog'lu, I. Badak, M. Cikirikciog'lu, T. Bakalim, T. Yag'di, S. Buket, and A. Hamulu The effects of modified hemofiltration on inflammatory mediators and cardiac performance in coronary artery bypass grafting Perfusion, March 1, 2000; 15(2): 143 - 150. [Abstract] [PDF]
|
|
|
|
|
|
E. Darling, S. Harris-Holloway, F. H Kern, R. Ungerleider, J. Jaggers, S. Lawson, and I. Shearer Impact of modifying priming components and fluid administration using miniaturized circuitry in neonatal cardiopulmonary bypass Perfusion, January 1, 2000; 15(1): 3 - 12. [Abstract] [PDF]
|
|
|
|
|
|
M. J Elliott Recent advances in paediatric cardiopulmonary bypass Perfusion, July 1, 1999; 14(4): 237 - 246. [PDF]
|
|
|
|
|
|
F. A. Portela, A. Pensado, A. Sanchez, R. Espanol, and C. Zavanella A simple technique to perform combined ultrafiltration Ann. Thorac. Surg., March 1, 1999; 67(3): 859 - 861. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. A. Hennein, U. Kiziltepe, S. Barst, K. A. Bocchieri, A. Hossain, D. R. Call, D. G. Remick, and J. P. Gold VENOVENOUS MODIFIED ULTRAFILTRATION AFTER CARDIOPULMONARY BYPASS IN CHILDREN: A PROSPECTIVE RANDOMIZED STUDY J. Thorac. Cardiovasc. Surg., March 1, 1999; 117(3): 496 - 505. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Aeba, T. Matayoshi, T. Katogi, and S. Kawada Speed-controlled venovenous modified ultrafiltration for pediatric open heart operations Ann. Thorac. Surg., November 1, 1998; 66(5): 1835 - 1836. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Rivera, T. R. Kimball, W. W. Bailey, S. A. Witt, P. R. Khoury, and S. R. Daniels Effect of veno-venous ultrafiltration on myocardial performance immediately after cardiac surgery in children: A prospective randomized study J. Am. Coll. Cardiol., September 1, 1998; 32(3): 766 - 772. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Wang, H. M. Huang, De Ming Zhu, H. Chen, Z. K. Su, and W. X. Ding Modified ultrafiltration in paediatric cardiopulmonary bypass Perfusion, September 1, 1998; 13(5): 304 - 310. [Abstract] [PDF]
|
|
|
|
|
|
R. M. Ungerleider Effects of Cardiopulmonary Bypass and Use of Modified Ultrafiltration Ann. Thorac. Surg., June 1, 1998; 65(90060): S35 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Gurbuz, W. M. Novick, C. A. Pierce, and D. C. Watson Impact of Ultrafiltration on Blood Use for Atrial Septal Defect Closure in Infants and Children Ann. Thorac. Surg., April 1, 1998; 65(4): 1105 - 1109. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Darling, K. Nanry, I. Shearer, D. Kaemmer, and S. Lawson Techniques of paediatric modified ultrafiltration: 1996 survey results Perfusion, March 1, 1998; 13(2): 93 - 103. [Abstract] [PDF]
|
|
|
|
|
|
J.-J. Chu, C.-H. Chang, P. J. Lin, W.-J. Su, and P. P. C. Tan One-Stage Sternal Stenting With Homograft Bone After Cardiac Operation in Pediatric Patients Ann. Thorac. Surg., March 1, 1998; 65(3): 846 - 847. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Bando, P. Vijay, M. W. Turrentine, T. G. Sharp, L. J. Means, G. J. Ensing, B. J. Lalone, Y. Sekine, L. Szekely, and J. W. Brown Dilutional And Modified Ultrafiltration Reduces Pulmonary Hypertension After Operations For Congenital Heart Disease: A Prospective Randomized Study J. Thorac. Cardiovasc. Surg., March 1, 1998; 115(3): 517 - 527. [Abstract] [Full Text]
|
|
|
|
|
|
L. Schlunzen, J. Pedersen, K. Hjortholm, O. K Hansen, and E. Ditlevsen Modified ultrafiltration in paediatric cardiac surgery Perfusion, March 1, 1998; 13(2): 105 - 109. [Abstract] [PDF]
|
|
|
|
|
|
C. W. Daggett, A. J. Lodge, J. E. Scarborough, P. J. Chai, J. Jaggers, and R. M. Ungerleider Modified Ultrafiltration Versus Conventional Ultrafiltration: A Randomized Prospective Study In Neonatal Piglets J. Thorac. Cardiovasc. Surg., February 1, 1998; 115(2): 336 - 342. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Davies, K. Nguyen, J. W. Gaynor, M. J. Elliott, and M. R. de Leval Modified Ultrafiltration Improves Left Ventricular Systolic Function In Infants After Cardiopulmonary Bypass J. Thorac. Cardiovasc. Surg., February 1, 1998; 115(2): 361 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Shin'oka, D. Shum-Tim, P. C. Laussen, S. M. Zinkovsky, H. G. W. Lidov, A. d. Plessis, and R. A. Jonas Effects of Oncotic Pressure and Hematocrit on Outcome After Hypothermic Circulatory Arrest Ann. Thorac. Surg., January 1, 1998; 65(1): 155 - 164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Friesen, D. N. Campbell, D. R. Clarke, and M. A. Tornabene Modified Ultrafiltration Attenuates Dilutional Coagulopathy in Pediatric Open Heart Operations Ann. Thorac. Surg., December 1, 1997; 64(6): 1787 - 1789. [Abstract] [Full Text]
|
|
|
|
|
|
P. J. del Nido Myocardial Protection and Cardiopulmonary Bypass in Neonates and Infants Ann. Thorac. Surg., September 1, 1997; 64(3): 878 - 879. [Full Text]
|
|
|
|
 |
|
 A. J. du Plessis Topical Review: Cerebral Hemodynamics and Metabolism During Infant Cardiac Surgery. Mechanisms of Injury and Strategies for Protection J Child Neurol, August 1, 1997; 12(5): 285 - 300. [Abstract] [PDF]
|
|
|
|
|
|
T. C. Koutlas, J. W. Gaynor, S. C. Nicolson, J. M. Steven, G. Wernovsky, and T. L. Spray Modified Ultrafiltration Reduces Postoperative Morbidity After Cavopulmonary Connection Ann. Thorac. Surg., July 1, 1997; 64(1): 37 - 42. [Abstract] [Full Text]
|
|
|
|
|
|
L. A. Skaryak, P. M. Kirshbom, L. R. DiBernardo, F. H. Kern, W. J. Greeley, R. M. Ungerleider, J. W. Gaynor, and S. b. D. C. Sabiston Jr. Modified ultrafiltration improves cerebral metabolic recovery after circulatory arrest J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 744 - 752. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
