Postfiltration und Lungenperfusion

Einfache Modifikation der Herz-Lungen-Maschine
Kardiotechnik/EKZ

Zusammenfassung

Die Hämofiltration während herzchirurgischer Interventionen mit der Herz-Lungen-Maschine (HLM) ist eine gebräuchliche Methode, um einen Volumenüberschuss und inflammatorische Reaktionen des Körpers zu reduzieren bzw. Entgleisungen zu korrigieren. Je nach Größe der verwendeten Filtrationsmembran wird zwischen Mikro-, Ultra- oder Nanofiltration unterschieden. In der Kinderherzchirurgie sind sowohl die Ultrafiltration während der extrakorporalen Zirkulation (EKZ) als auch die Methode der modifizierten Ultrafiltration (MUF) nach Beenden der EKZ standardisierte Verfahren. In der Erwachsenherzchirurgie werden seit vielen Jahren die Vorteile der Hämofiltration genutzt. In der Abteilung für Thorax-, Herz-, und Thorakale Gefäßchirurgie des Universitätsklinikums Frankfurt werden Hämofilter im Bedarfsfall während Eingriffen mit der HLM oder nach Abgehen von der HLM als Postfiltration eingesetzt. Im vorliegenden Beitrag werden die Adaptationen der HLM beschrieben, die eine einfache und flexible Anwendung der Postfiltration über die liegenden Kanülen erlauben. Weiterhin wird das Set-up zur Lungenperfusion beschrieben.

Schlüsselwörter

Hämofiltration Extrakorporale Zirkulation Ultrafiltration Kardioplegie Perfusion 

Postfiltration and lung perfusion

Simple modification of heart-lung machines

Abstract

Hemofiltration is a useful method to reduce fluid overload and inflammatory response in patients undergoing open heart surgery with heart-lung machines (HLM). A differentiation is made between microfiltration, ultrafiltration and nanofiltration depending on the size of the filtration membrane used. In pediatric heart surgery the procedure of ultrafiltration during extracorporeal circulation (ECC) and the so-called modified ultrafiltration (MUF) following ECC are well established procedures after cardiopulmonary bypass (CPB) operations. The advantages of hemofiltration techniques during and after CPB in adults have been used for many years. In the department for thoracic and cardiac vascular surgery of the University Clinic in Frankfurt hemofilters are employed during interventions with a HLM or after disconnection from the HLM as postfiltration. In this article adaptations of the HLM which allow the simple and flexible application of postfiltration via an in-dwelling cannula and lung perfusion techniques are described.

Keywords

Hemofiltration Extracorporeal circulation Ultrafiltration Cardioplegia Perfusion 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Abteilung für Thorax-, Herz- und Thorakale GefäßchirurgieUniversitätsklinikum Frankfurt, Goethe-UniversitätFrankfurt a. M.Deutschland

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