<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.0905.429_s_001_w2aab3b7b2b1b6b1aab1c16b1Aa"><h3>Background</h3><p>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.</p></sec><sec id="j_1905-7415.0905.429_s_002_w2aab3b7b2b1b6b1aab1c16b2Aa"><h3>Objectives</h3><p>To evaluate evidence for the effects of MUF on clinical outcomes of cardiac surgery in pediatric and adult patients.</p></sec><sec id="j_1905-7415.0905.429_s_003_w2aab3b7b2b1b6b1aab1c16b3Aa"><h3>Methods</h3><p>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.</p></sec><sec id="j_1905-7415.0905.429_s_004_w2aab3b7b2b1b6b1aab1c16b4Aa"><h3>Results</h3><p>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.</p></sec><sec id="j_1905-7415.0905.429_s_005_w2aab3b7b2b1b6b1aab1c16b5Aa"><h3>Conclusions</h3><p>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.</p></sec></abstract>

BackgroundCardiopulmonary 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.ObjectivesTo evaluate evidence for the effects of MUF on clinical outcomes of cardiac surgery in pediatric and adult patients.MethodsA 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.ResultsOur 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.ConclusionsMUF 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.

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

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundCardiopulmonary bypass (CPB) can contribute to the development of an inflammatory response and postsurgical morbidity. Conventional ultrafiltration...

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

Article Category: Review article

Publié en ligne: 31 janv. 2017

Pages: 591 - 599

DOI: https://doi.org/10.5372/1905-7415.0905.429

Mots clés
Adult cardiac surgery, cardiopulmonary bypass, conventional ultrafiltration, modified ultrafiltration, pediatric cardiac surgery

© 2015 Siraphop Thapmongkol, Patarabutr Masaratana, Thaworn Subtaweesin, Jarun Sayasathid, Kanthachat Thatsakorn, Jule Namchaisiri

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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

Article Category: Review article

Publié en ligne: 31 janv. 2017

Pages: 591 - 599

DOI: https://doi.org/10.5372/1905-7415.0905.429

Mots clésAdult cardiac surgery, cardiopulmonary bypass, conventional ultrafiltration, modified ultrafiltration, pediatric cardiac surgery

© 2015 Siraphop Thapmongkol, Patarabutr Masaratana, Thaworn Subtaweesin, Jarun Sayasathid, Kanthachat Thatsakorn, Jule Namchaisiri

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
Adult cardiac surgery, cardiopulmonary bypass, conventional ultrafiltration, modified ultrafiltration, pediatric cardiac surgery