The benefits of continuous ultrafiltration in pediatric cardiac surgery

Abstract

MUF decreases the duration of mechanical ventilatory support, the length of intensive care unit stay, the need for blood transfusion and improves postoperative hemodynamics. It is associated with increased levels of hemoglobin, hematocrit and platelets. We can conclude that MUF attenuates the inflammatory response by decreasing the levels of inflammatory mediators.

Fast-tracking in pediatric cardiac surgery - The current standing

“…Efforts should be made to reduce the inflammatory response typically seen with long CPB times and circulatory arrest. Various ultrafiltration techniques are already being used frequently, [34][35][36] and newer developments such as low priming volume CPB circuits for infants and small children, [37,38] and the use of hypertonic solutions, [39,40] are promising strategies to decrease blood transfusion requirements, extravascular lung water, and positive fluid balance, all of which can influence the fasttracking. A detailed discussion about the pros and cons of these techniques is beyond the scope of this review.…”

Effect of Flow Rate, Negative Pressure, and Duration of Modified Ultrafiltration on Hemodynamics and Inflammatory Mediators

“…Now, many studies show that MUF not only increases the hematocrit and colloid pressure but also improves cardiac function and alleviates edema, especially in pediatric operations. 2,3 Generally, flow rate during MUF is 10 to 15 ml/kg per minute and the duration of MUF is approximately 15 minutes, which sometimes is longer than surgeons expect. In this study, the MUF time was shortened by high flow rate or high negative pressure, and the effects of various flow rates, negative pressure, and duration of MUF on hemodilution, hemodynamics, and inflammatory reaction were evaluated.…”

Novalung enables protective ventilation in acute lung injury

“…Continuous ultrafiltration decreases concentrations of inflammatory mediators, increases concentrations of haemoglobin, haematocrit and platelets, improves postoperative haemodynamics, and decreases the need for blood transfusion, the duration of mechanical ventilatory support, and the length of stay in the intensive care unit (ICU) [1]. The use of continuous ultrafiltration may be effective in preventing hepatic decompensation in cirrhotic patients after valvular heart surgery with cardiopulmonary bypass (CPB).…”

“…Acute lung injury in PGD continues to be a major cause of morbidity and mortality following lung transplantation ................................................................................................................................................................................................................... [1]. Often this is worsened by ventilator associated lung injury.…”

“…However, a recent meta-analysis and systemic review article comparing the analgesic efficacy and side-effects of epidural versus paravertebral blockade for thoracotomy concluded that although the analgesia was comparable, paravertebral blockade had a better side-effect profile [1]. The aim of this study of pneumonectomy outcome was to examine UK anaesthetic practice, firstly to obtain the incidences of analgesic techniques used, and secondly to determine if there were any associations between the mode of analgesia and major complications.…”