Abstract
Objective
Modified ultrafiltration increases blood pressure after cardiopulmonary bypass in children. To investigate the cause of this hemodynamic improvement, we assessed the relationship between increased blood pressure and hematocrit.
Methods
We retrospectively assessed 30 consecutive patients who underwent ventricular septal defect closure, and divided them into two groups: group M (modified ultrafiltration, n = 15) and group C (conventional ultrafiltration, n = 15). We compared the intraoperative transitions of blood pressure and hematocrit, and analyzed the correlations between blood pressure and hematocrit at 15 min after cardiopulmonary bypass (immediately after modified ultrafiltration in group M) and between the percent increases in blood pressure and hematocrit during modified ultrafiltration.
Results
Although intraoperative central venous pressure and dopamine dosage were similar, in group M, increases in hematocrit (26.4% ± 4.9% to 31.9% ± 5.7%, P < 0.01) and systolic blood pressure (61.1 ± 10.3 to 75.6 ± 11.5 mmHg, P < 0.01) occurred during modified ultrafiltration. Furthermore, diastolic and mean blood pressure at 15 min after cardiopulmonary bypass (after modified ultrafiltration) were higher in group M than in group C. However, systolic, mean, and diastolic blood pressure were not correlated with increased hematocrit after modified ultrafiltration, and there was also no correlation between the percent increases in each blood pressure and hematocrit.
Conclusion
Modified ultrafiltration increased blood pressure and hematocrit immediately after cardiopulmonary bypass in children. However, no correlations were detected between the increases in blood pressure and hematocrit. These results indicate hemoconcentration is not the major cause of the increased blood pressure during modified ultrafiltration.
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References
M Fujita M Ishihara Y Kusama M Shimizu T Kimura Y Iizuka et al. (2004) ArticleTitleEffect of modified ultrafiltration on inflammatory mediators, coagulation factors, and other proteins in blood after an extracorporeal circuit Artif Organs 28 310–3 Occurrence Handle1:CAS:528:DC%2BD2cXktVOkurc%3D Occurrence Handle15046631 Occurrence Handle10.1111/j.1525-1594.2004.47230.x
MA Maluf C Mangia C Silva WB Carvalho AC Carvalho E Buffolo (2001) ArticleTitleConventional and conventional plus modified ultrafiltration during cardiac surgery in high-risk congenital heart disease J Cardiovasc Surg (Torino) 42 465–73 Occurrence Handle1:STN:280:DC%2BD38%2FitlansQ%3D%3D
K Bando MW Turrentine P Vijay TG Sharp Y Sekine BJ Lalone et al. (1998) ArticleTitleEffect of modified ultrafiltration in high-risk patients undergoing operations for congenital heart disease Ann Thorac Surg 66 821–8 Occurrence Handle1:STN:280:DyaK1cvjvFyksQ%3D%3D Occurrence Handle9768937 Occurrence Handle10.1016/S0003-4975(98)00606-7
MJ Davies K Nguyen JW Gaynor MJ Elliott (1998) ArticleTitleModified ultrafiltration improves left ventricular systolic function in infants after cardiopulmonary bypass J Thorac Cardiovasc Surg 115 361–70 Occurrence Handle1:STN:280:DyaK1c7jtlKkug%3D%3D Occurrence Handle9475531 Occurrence Handle10.1016/S0022-5223(98)70280-6
RR Chaturvedi DF Shore PA White MH Scallan JW Gothard AN Redington et al. (1999) ArticleTitleModified ultrafiltration improves global left ventricular systolic function after open-heart surgery in infants and children Eur J Cardiothorac Surg 15 742–6 Occurrence Handle1:STN:280:DyaK1MzlvVOquw%3D%3D Occurrence Handle10431852 Occurrence Handle10.1016/S1010-7940(99)00101-3
RG Leyh C Bartels E Joubert-Hubner JF Bechtel HH Sievers (2001) ArticleTitleInfluence of modified ultrafiltration on coagulation, fibrinolysis and blood loss in adult cardiac surgery Eur J Cardiothorac Surg 19 145–51 Occurrence Handle1:STN:280:DC%2BD3M3lsl2ltg%3D%3D Occurrence Handle11167103 Occurrence Handle10.1016/S1010-7940(00)00633-3
JM Costello CL Backer PA Checchia C Mavroudis RG Seipelt DM Goodman (2004) ArticleTitleAlterations in the natriuretic hormone system related to cardiopulmonary bypass in infants with congestive heart failure Pediatr Cardiol 25 347–53 Occurrence Handle1:STN:280:DC%2BD2critVWkug%3D%3D Occurrence Handle14735254 Occurrence Handle10.1007/s00246-003-0512-5
RM Ungerleider (1998) ArticleTitleEffects of cardiopulmonary bypass and use of modified ultrafiltration Ann Thorac Surg 65 S35–89 Occurrence Handle1:STN:280:DyaK1czgvFemsw%3D%3D Occurrence Handle9647136 Occurrence Handle10.1016/S0003-4975(98)00327-0
T Kameyama F Ando F Okamoto M Hanada K Yamanaka N Sasahashi et al. (2000) ArticleTitleThe effect of modified ultrafiltration in pediatric open heart surgery Ann Thorac Cardiovasc Surg 6 19–26 Occurrence Handle1:STN:280:DC%2BD3c3htlKnsg%3D%3D Occurrence Handle10748355
T Hiramatsu Y Imai H Kurosawa Y Takanashi M Aoki T Shinoka et al. (2002) ArticleTitleEffects of dilutional and modified ultrafiltration in plasma endothelin-1 and pulmonary vascular resistance after the Fontan procedure Ann Thorac Surg 73 861–5 Occurrence Handle11899192
J Grunenfelder G Zund A Schoeberlein FE Maly U Schurr S Guntli et al. (2000) ArticleTitleModified ultrafiltration lowers adhesion molecule and cytokine levels after cardiopulmonary bypass without clinical relevance in adults Eur J Cardiothorac Surg 17 77–83 Occurrence Handle1:STN:280:DC%2BD3c7pslClsQ%3D%3D Occurrence Handle10735416 Occurrence Handle10.1016/S1010-7940(99)00355-3
JM Pearl PB Manning JL McNamara MM Saucier DW Thomas (1999) ArticleTitleEffect of modified ultrafiltration on plasma thromboxane B2, leukotriene B4, and endothelin-1 in infants undergoing cardiopulmonary bypass Ann Thorac Surg 68 1369–75 Occurrence Handle1:STN:280:DC%2BD3c%2FgvVymsQ%3D%3D Occurrence Handle10543508 Occurrence Handle10.1016/S0003-4975(99)00978-9
H Huang T Yao W Wang D Zhu W Zhang H Chen et al. (2003) ArticleTitleContinuous ultrafiltration attenuates the pulmonary injury that follows open heart surgery with cardiopulmonary bypass Ann Thorac Surg 76 136–40 Occurrence Handle12842527 Occurrence Handle10.1016/S0003-4975(03)00264-9
PA Berdat E Eichenberger J Ebell JP Pfammatter M Pavlovic C Zobrist et al. (2004) ArticleTitleElimination of proinflammatory cytokines in pediatric cardiac surgery: analysis of ultrafiltration method and filter type J Thorac Cardiovasc Surg 127 1688–96 Occurrence Handle1:CAS:528:DC%2BD2cXlsFCltLw%3D Occurrence Handle15173725 Occurrence Handle10.1016/j.jtcvs.2004.01.030
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Takabayashi, S., Shimpo, H., Yokoyama, K. et al. Relationship between increased blood pressure and hematocrit during modified ultrafiltration for pediatric open heart surgery. Gen Thorac Cardiovasc Surg 55, 12–18 (2007). https://doi.org/10.1007/s11748-006-0067-5
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DOI: https://doi.org/10.1007/s11748-006-0067-5