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Ann Thorac Surg 1998;65:S35-S39
© 1998 The Society of Thoracic Surgeons

Effects of Cardiopulmonary Bypass and Use of Modified Ultrafiltration

Ross M. Ungerleider, MDa

a Division of Thoracic Surgery and Pediatrics, Duke University Medical Center, Durham, North Carolina, USA

Address reprint requests to Dr Ungerleider, Duke University Medical Center, Box 3178, Durham, NC 27710

Presented at Risk Assessment of Major Perioperative Issues in Pediatric Cardiac Surgery, Washington, DC, May 7, 1997.

Background. Hemodilution is a prominent problem in cardiopulmonary bypass in a pediatric population. Ultrafiltration is a method used to reduce fluid volume and tissue edema and to increase hematocrit without the need for blood products. Modified ultrafiltration may offer advantages in comparison with conventional ultrafiltration.

Methods. This article reviews the technique of modified ultrafiltration and its use, results, complications, and safety in pediatric cardiopulmonary bypass.

Results. Modified ultrafiltration in pediatric cardiopulmonary bypass reduces total body water and serum levels of inflammatory mediators. It results in an elevated hematocrit without the need for transfusion, improved pulmonary compliance in the immediate postbypass period, and probably improved cerebral metabolic recovery after deep hypothermic circulatory arrest.

Conclusions. Modified ultrafiltration can be performed safely in neonatal patients after cardiopulmonary bypass and offers advantages in comparison with conventional ultrafiltration.




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