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Published on: August 19, 2020
Influence of high-flow modified ultrafiltration on brain oxygenation and perfusion during surgery for children with
Zaishen Jia1, Yichao Teng2, Yuan Liu1
11 Department of Extracorporeal Circulation, Centre for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
Background:
Modified ultrafiltration (MUF) can be performed in infants with ventricular septal defects (VSDs) after cardiopulmonary bypass (CPB) to reduce haemodilution and its potential adverse effects. High-flow MUF might reduce ultrafiltration duration and hasten the necessary correction of haemodilution during CPB. However, its influence on brain oxygenation remains controversial.
Objective:
This non-randomized, prospective, pilot study aimed to investigate the influence of high-flow MUF on brain oxygenation in infants with VSDs.
Methods:
High-flow MUF (≥20 mL/kg/min) was performed in twenty infants. Brain oxygen saturation (rSO2) and tissue haemoglobin index (tHI) were non-invasively and continuously measured intraoperatively using near-infrared spectroscopy (NIRS). Transcranial Doppler non-invasively detected the mean flow velocity of the middle cerebral artery (Vmean).
Results:
rSO2 increased significantly during MUF, as did tHI, Vmean, mean arterial pressure and haematocrit (all p<0.05). No correlation was found between changes in rSO2 and changes in other parameters (all p≥0.05).
Conclusion:
In infants with ventricular septal defects managed with CPB during VSDs repair, high-flow MUF did not reduce brain oxygenation.
