High-volume, zero balanced ultrafiltration improves pulmonary function in a model of post-pump syndrome

Area of Science:

• Cardiovascular Surgery
• Pulmonary Medicine
• Critical Care Medicine

Background:

• Systemic inflammatory response syndrome (SIRS) can occur after cardiopulmonary bypass (CPB), leading to complications in open-heart surgery.
• Cytokines are inflammatory mediators implicated in SIRS development.
• Zero Balance Ultrafiltration (Z-BUF) may reduce CPB-associated inflammatory mediators and mitigate adverse effects.

Purpose of the Study:

• To investigate the efficacy of Zero Balance Ultrafiltration (Z-BUF) in attenuating lung injury and inflammation following cardiopulmonary bypass (CPB).
• To evaluate the impact of Z-BUF on pulmonary function, edema, and inflammatory markers in a porcine model.

Main Methods:

• Yorkshire pigs underwent 60 minutes of CPB.
• Post-CPB, animals received an endotoxin infusion and were monitored for 3.5 hours.
• One group received high-volume Z-BUF; the control group did not. Hemodynamics, blood gases, pulmonary function, lung water content, Interleukin-8 (IL-8) levels, and lung histology were assessed.

Main Results:

• The Z-BUF group maintained significantly higher arterial PO2 levels compared to the unfiltered group post-CPB.
• Pulmonary compliance was reduced in both groups, but less severely in the Z-BUF group.
• Lung wet/dry ratios and histological analysis indicated reduced pulmonary edema and injury in the Z-BUF group.

Conclusions:

• Zero Balance Ultrafiltration (Z-BUF) significantly improves arterial oxygenation and lung compliance following cardiopulmonary bypass.
• Z-BUF effectively reduces pulmonary edema and lung injury in a porcine model of post-CPB systemic inflammatory response syndrome (SIRS).
• Z-BUF demonstrates a protective effect against CPB-induced lung damage.