Pulmonary function after modified venovenous ultrafiltration in infants: A prospective, randomized trial

Keenan, Heather T.; Thiagarajan, Ravi R.; Stephens, Kenton E.; Williams, Glyn D.; Ramamoorthy, Chandra; Lupinetti, Flavian M.

doi:10.1016/s0022-5223(00)70129-2

Cited by 56 publications

(53 citation statements)

References 13 publications

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“…This observation is common to most clinical series in both the pediatric 14,23 and the adult populations. 15,16 It is conceivable that standardized institutional policies on patient management may attenuate any discrepancy in outcome.…”

Section: I-256 Circulation September 18 2001mentioning

confidence: 76%

“…15,16 Observations made in the pediatric population, including high-risk patients, have shown that ultrafiltration after cardiopulmonary bypass is associated with a mortality rate similar to the estimate for control patients. 7,9,11,12,14 Apparently, the severity of heart disease and the complexity of the operation have a more direct influence on operative mortality than bypass-related inflammatory reaction. The fact that the majority of early casualties in this study were due to untoward cardiac events would support this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies in children have shown improvement of pulmonary function after ultrafiltration in terms of lung compliance, pulmonary vascular resistance, and oxygenation. 12,14,23 The net clinical effect of these changes, with time to extubation used as an end point, has often been controversial. 12,14,19,23 Likewise, experience in adults has demonstrated decreases in postoperative intrapulmonary shunt fraction after ultrafiltration.…”

Section: I-256 Circulation September 18 2001mentioning

confidence: 99%

“…12,14,23 The net clinical effect of these changes, with time to extubation used as an end point, has often been controversial. 12,14,19,23 Likewise, experience in adults has demonstrated decreases in postoperative intrapulmonary shunt fraction after ultrafiltration. 15 Nevertheless, the conclusions regarding duration of mechanical ventilatory support have thus far been conflicting.…”

Section: I-256 Circulation September 18 2001mentioning

confidence: 99%

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Modified Ultrafiltration Reduces Morbidity After Adult Cardiac Operations

Luciani

Menon²,

Vecchi³

et al. 2001

Circulation

107

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Background-Extracorporeal circulation contributes to morbidity after open-heart surgery by causing a systemic inflammatory reaction. Modified ultrafiltration is a technique able to remove the fluid overload and inflammatory mediators associated with use of cardiopulmonary bypass. It has been shown to reduce morbidity after cardiac operations in children, but the impact on adult cardiac procedures is unknown. Methods and Results-Five hundred seventy-three consecutive adult patients were prospectively randomized to either ultrafiltration after cardiopulmonary bypass (treatment) or to no ultrafiltration (control). Parsonnet score was used to assess the severity of the patients' clinical conditions.

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Section: I-256 Circulation September 18 2001mentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: I-256 Circulation September 18 2001mentioning

confidence: 99%

Section: I-256 Circulation September 18 2001mentioning

confidence: 99%

See 2 more Smart Citations

Modified Ultrafiltration Reduces Morbidity After Adult Cardiac Operations

Luciani

Menon²,

Vecchi³

et al. 2001

Circulation

107

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“…Because MUF can eliminate excess water and ameliorate inflammatory reactions, it is unsurprising that the advantages of MUF on pulmonary function have been noted and widely accepted. In children, improvements of pulmonary function indexes including lung compliance, pulmonary vascular resistance, and oxygenation after ultrafiltration have been shown [7,13,14,31,41,48,49]. Nevertheless, a meta-analysis of RCT in pediatric patients failed to demonstrate the benefit of MUF on postoperative ventilation time.…”

Section: Effects Of Muf On Pulmonary Functionmentioning

confidence: 99%

The effects of modified ultrafiltration on clinical outcomes of adult and pediatric cardiac surgery

et al. 2015

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Background: Cardiopulmonary bypass (CPB) can contribute to the development of an inflammatory response and postsurgical morbidity. Conventional ultrafiltration and modified ultrafiltration (MUF) can mitigate the adverse effects of CPB by removing free water and inflammatory mediators, at least in part. Objectives: To evaluate evidence for the effects of MUF on clinical outcomes of cardiac surgery in pediatric and adult patients. Methods: A literature review of MEDLINE-indexed articles published between 1990 and June 2014 was conducted on PubMed. A search on the CTS.net website and the Cochrane Central Register of Controlled Trials was also performed with relevant keywords. The search was limited to English language articles and human studies. Results: Our primary search identified 84 potential articles, of which 55 articles were relevant to conventional ultrafiltration, modified ultrafiltration, ultrafiltration, cardiopulmonary bypass, extracorporeal circulation, pediatric and adult cardiac surgery. There were 3 meta-analyses, 7 review literatures, 21 randomized controlled trials. The remainder consisted of 18 controlled and 6 observational studies. MUF has been beneficial effects on postoperative bleeding, chest drainage, transfusion requirement, and improvement cardiac function, but effects in adult cardiac surgery inconclusive because data was relatively limited. Conclusions: MUF may improve post-CPB hemodynamic activity and cardiac function in pediatric cardiac surgery. By contrast, the clinical trials in adults are limited mostly by small sample sizes that preclude an adequately powered assessment of clinically relevant outcomes. The available data are conflicting and several studies show no differential outcomes. Further studies are required to identify patients who will most likely benefit from ultrafiltration and to establish standard protocols.

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