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Modified ultrafiltration versus conventional ultrafiltration: a randomized prospective study in neonatal piglets
C W Daggett1, A J Lodge, J E Scarborough
1Duke University Medical Center, Department of Surgery, Durham, NC 27710, USA.
The Journal of Thoracic and Cardiovascular Surgery
|February 25, 1998
Summary
Modified ultrafiltration significantly reduces body weight gain and myocardial edema in neonatal piglets after cardiopulmonary bypass. This technique also improves hemodynamics and left ventricular function compared to conventional methods.
Area of Science:
- Neonatal physiology
- Cardiovascular surgery
- Extracorporeal circulation
Background:
- Cardiopulmonary bypass (CPB) in neonates increases inflammatory mediators, leading to edema and potential multiple organ dysfunction.
- Conventional and modified ultrafiltration are clinical strategies to mitigate CPB-induced complications.
Purpose of the Study:
- To evaluate the efficacy of conventional and modified ultrafiltration in preventing weight gain, myocardial edema, and left ventricular dysfunction in neonatal piglets undergoing CPB.
Main Methods:
- A randomized prospective study involving 18 1-week-old piglets undergoing CPB.
- Measurements included body weight, myocardial wet/dry ratios, mean arterial pressure, and left ventricular preload-recruitable stroke work (PRSW).
- Assessments were performed before CPB and at 10, 60, and 120 minutes after separation from bypass.
Main Results:
- Modified ultrafiltration (MUF) significantly reduced total body weight gain compared to conventional ultrafiltration (CUF) and no filtration (control).
- MUF improved myocardial wet/dry ratios, indicating reduced edema, while CUF did not show significant improvement over control.
- Hemodynamically, MUF was superior in increasing mean arterial pressure and left ventricular PRSW post-CPB.
Conclusions:
- Modified ultrafiltration is more effective than conventional ultrafiltration and no filtration in managing CPB-induced complications in neonatal piglets.
- MUF reduces weight gain, myocardial edema, and improves hemodynamic parameters and left ventricular contractility.
- These findings suggest MUF as a superior strategy for neonatal CPB.