Postoperative hemoglobin changes following ultrafiltration in cardiac patients

Area of Science:

• Cardiovascular Surgery
• Nephrology
• Critical Care Medicine

Background:

• Cardiac surgery with cardiopulmonary bypass (CPB) often involves fluid shifts and potential hemodilution.
• Conventional Ultrafiltration (CUF) is used during CPB to manage fluid balance.
• The impact of varying CUF thresholds on postoperative hemoglobin (HGB) levels requires further investigation.

Purpose of the Study:

• To investigate the relationship between different Conventional Ultrafiltration (CUF) thresholds and postoperative hemoglobin (HGB) levels in patients undergoing cardiac surgery with CPB.

Main Methods:

• Retrospective study using EPIC and STS data.
• Three groups: no CUF (n=106), low CUF (<20 mL/kg; n=33), high CUF (≥20 mL/kg; n=18).
• HGB assessed pre-op, end-bypass, ICU, discharge, and 30 days post-op; IV fluid volume at 72 hours evaluated.

Main Results:

• No significant HGB difference pre-op, end-bypass, or early ICU stay across groups.
• At discharge, non-CUF group had higher HGB than high CUF (p=0.028).
• At 30 days, low CUF group had significantly higher HGB than high CUF (p=0.022). No difference in IV fluid volume at 72 hours.

Conclusions:

• Low CUF is superior to no CUF and high CUF for preserving HGB levels up to 30 days post-cardiac surgery.
• CUF, regardless of volume, was not associated with increased postoperative IV fluid resuscitation.