Hemofiltration during cardiopulmonary bypass for high risk adult cardiac surgery

J. S. Raman, M. Hata, Rinaldo Bellomo, K. Kohchi, H. L. Cheung, B. F. Buxton

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Abstract

Aims: The role of hemofiltration (HF) during cardiopulmonary bypass (CPB) in adult cardiac surgery is controversial. It may be beneficial during prolonged CPB in high-risk surgery. Accordingly, we sought to compare two groups of patients undergoing high-risk cardiac surgery with or without HF. Methods: One hundred and eighteen patients who underwent complex cardiac surgical procedures during a 12-month period were divided into two groups. Group I (n=61) comprised patients who were treated with hemofiltration during CPB. Group II (n=57) were not filtered. Estimated risk of death, standard demographic, clinical and surgical features were obtained and predetermined outcomes were studied. Statistical comparisons were made. Results: Age, procedure times and mortality rates were similar in both groups. The mean volume of fluid removed in group I was 3.4 L. The preoperative mean Parsonnet score was 24.8 in group I and 22.5 in group II (ns). Postoperative serum hemoglobin, hematocrit, platelet, and albumin levels were all significantly higher in group I patients (p = 0.0015) indicating hemoconcentration. Post-operative chest drainage showed a trend toward decreased post-operative bleeding in group I (p=0.065). Postoperative pleural effusions requiring chest tube drainage were significantly less in group I (9.8% vs. 29.8% 6; p = 0.0062). The incidence of lung infection was also decreased from 26.3% to 13.1% (p=0.05). Operative mortality was similar in both groups (11.4% in group I, 10.5% in group II, ns). Conclusion: Hemofiltration during CPB attenuates postoperative anemia, thrombocytopenia and hypoalbuminemia, may reduce post-operative bleeding and appears to decrease post-operative pulmonary complications.

Original languageEnglish
Pages (from-to)753-757
Number of pages5
JournalInternational Journal of Artificial Organs
Volume26
Issue number8
Publication statusPublished - 1 Aug 2003
Externally publishedYes

Keywords

  • Cardiopulmonary bypass
  • Hemofiltration
  • Open heart surgery
  • Perfusion
  • Post-operative care

Cite this

Raman, J. S., Hata, M., Bellomo, R., Kohchi, K., Cheung, H. L., & Buxton, B. F. (2003). Hemofiltration during cardiopulmonary bypass for high risk adult cardiac surgery. International Journal of Artificial Organs, 26(8), 753-757.