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The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery
BACKGROUND: Cardiopulmonary bypass is associated with increased fluid accumulation around the heart which influences pulmonary and cardiac diastolic function. The aim of this study was to compare the effects of modified ultrafiltration (MUF) versus conventional ultrafiltration (CUF) on duration of m...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331766/ https://www.ncbi.nlm.nih.gov/pubmed/28255321 http://dx.doi.org/10.4103/1735-1995.193504 |
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author | Ziyaeifard, Mohsen Alizadehasl, Azin Aghdaii, Nahid Rahimzadeh, Poupak Masoumi, Gholamreza Golzari, Samad EJ Fatahi, Mostafa Gorjipur, Farhad |
author_facet | Ziyaeifard, Mohsen Alizadehasl, Azin Aghdaii, Nahid Rahimzadeh, Poupak Masoumi, Gholamreza Golzari, Samad EJ Fatahi, Mostafa Gorjipur, Farhad |
author_sort | Ziyaeifard, Mohsen |
collection | PubMed |
description | BACKGROUND: Cardiopulmonary bypass is associated with increased fluid accumulation around the heart which influences pulmonary and cardiac diastolic function. The aim of this study was to compare the effects of modified ultrafiltration (MUF) versus conventional ultrafiltration (CUF) on duration of mechanical ventilation and hemodynamic status in children undergoing congenital heart surgery. MATERIALS AND METHODS: A randomized clinical trial was conducted on 46 pediatric patients undergoing cardiopulmonary bypass throughout their congenital heart surgery. Arteriovenous MUF plus CUF was performed in 23 patients (intervention group) and sole CUF was performed for other 23 patients (control group). In MUF group, arterial cannula was linked to the filter inlet through the arterial line, and for 10 min, 10 ml/kg/min of blood was filtered and returned via cardioplegia line to the right atrium. Different parameters including hemodynamic variables, length of mechanical ventilation, Intensive Care Unit (ICU) stay, and inotrope requirement were compared between the two groups. RESULTS: At immediate post-MUF phase, there was a statistically significant increase in the mean arterial pressure, systolic blood pressure, and diastolic blood pressure (P < 0.05) only in the study group. Furthermore, there was a significant difference in time of mechanical ventilation (P = 0.004) and ICU stay (P = 0.007) between the two groups. Inotropes including milrinone (P = 0.04), epinephrine (P = 0.001), and dobutamine (P = 0.002) were used significantly less frequently for patients in the intervention than the control group. CONCLUSION: Administration of MUF following surgery improves hemodynamic status of patients and also significantly decreases the duration of mechanical ventilation and inotrope requirement within 48 h after surgery. |
format | Online Article Text |
id | pubmed-5331766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-53317662017-03-02 The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery Ziyaeifard, Mohsen Alizadehasl, Azin Aghdaii, Nahid Rahimzadeh, Poupak Masoumi, Gholamreza Golzari, Samad EJ Fatahi, Mostafa Gorjipur, Farhad J Res Med Sci Original Article BACKGROUND: Cardiopulmonary bypass is associated with increased fluid accumulation around the heart which influences pulmonary and cardiac diastolic function. The aim of this study was to compare the effects of modified ultrafiltration (MUF) versus conventional ultrafiltration (CUF) on duration of mechanical ventilation and hemodynamic status in children undergoing congenital heart surgery. MATERIALS AND METHODS: A randomized clinical trial was conducted on 46 pediatric patients undergoing cardiopulmonary bypass throughout their congenital heart surgery. Arteriovenous MUF plus CUF was performed in 23 patients (intervention group) and sole CUF was performed for other 23 patients (control group). In MUF group, arterial cannula was linked to the filter inlet through the arterial line, and for 10 min, 10 ml/kg/min of blood was filtered and returned via cardioplegia line to the right atrium. Different parameters including hemodynamic variables, length of mechanical ventilation, Intensive Care Unit (ICU) stay, and inotrope requirement were compared between the two groups. RESULTS: At immediate post-MUF phase, there was a statistically significant increase in the mean arterial pressure, systolic blood pressure, and diastolic blood pressure (P < 0.05) only in the study group. Furthermore, there was a significant difference in time of mechanical ventilation (P = 0.004) and ICU stay (P = 0.007) between the two groups. Inotropes including milrinone (P = 0.04), epinephrine (P = 0.001), and dobutamine (P = 0.002) were used significantly less frequently for patients in the intervention than the control group. CONCLUSION: Administration of MUF following surgery improves hemodynamic status of patients and also significantly decreases the duration of mechanical ventilation and inotrope requirement within 48 h after surgery. Medknow Publications & Media Pvt Ltd 2016-11-07 /pmc/articles/PMC5331766/ /pubmed/28255321 http://dx.doi.org/10.4103/1735-1995.193504 Text en Copyright: © 2016 Journal of Research in Medical Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Ziyaeifard, Mohsen Alizadehasl, Azin Aghdaii, Nahid Rahimzadeh, Poupak Masoumi, Gholamreza Golzari, Samad EJ Fatahi, Mostafa Gorjipur, Farhad The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery |
title | The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery |
title_full | The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery |
title_fullStr | The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery |
title_full_unstemmed | The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery |
title_short | The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery |
title_sort | effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331766/ https://www.ncbi.nlm.nih.gov/pubmed/28255321 http://dx.doi.org/10.4103/1735-1995.193504 |
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