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Abstract
Cardiopulmonary bypass is associated with an accumulation of total body water and a systemic inflammatory response syndrome, which, in turn, is associated with organ dysfunction and postoperative morbidity. Among the therapeutic maneuvers proposed to mitigate the consequences of post perfusion syndrome, modified ultrafiltration has recently increasingly come into favor. The technique entails removal of water and low molecular weight substances under a hydrostatic pressure gradient after separation from cardiopulmonary bypass. It has been suggested that modified ultrafiltration may be capable of reducing SIRS and improving clinical outcome by filtering out the inflammatory mediators generated during CPB in pediatric studies. This study is undertaken in effort to evaluate the efficacy of MUF as safe, effective, useful technique to reduce the plasma levels of cytokines in adult patients undergoing elective cardiac surgery with cardiopulmonary bypass.
Sixty adult patients undergoing open heart surgery were included in this study. They were divided into two groups:
Study Group: included 30 patients had modified ultrafiltration for 15-20 minutes after termination of cardiopulmonary bypass.
Control Group: included 30 patients had no modified ultrafiltration.
Patients undergoing emergency surgery, or having a diagnosed systemic disorder such as hemostatic defect or renal failure or receiving drugs that could affect the inflammatory response as aprotonin or steroids were excluded from the study.