Modified ultrafiltration postextracorporeal membrane oxygenation

Modified ultrafiltration (MUF) has been widely used for the removal of extracellular water in the immediate postcardiopulmonary bypass (CPB) period. The reported benefits of this technique are improved hematological status and hemodynamic stability post-CPB, as well as a decrease in blood utilization during the operation. MUF has also been associated with improved pulmonary status along with enhanced myocardial performance. With these benefits in mind, we have explored the possible advantages of using MUF following extracorporeal membrane oxygenation (ECMO). The theoretical advantages of using MUF post-ECMO are the reduction of blood use prior to removal from ECMO for optimization of hemoglobin levels, improved pulmonary compliance decreasing the duration of ventilatory support, improved myocardial function, as well as the other reported benefits described with MUF post-CPB. This report communicates the technique used to perform MUF post-ECMO, as well as a simple MUF circuit design for use in the intensive care unit setting.