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Title: Hemofiltration during cardiopulmonary bypass for high risk adult cardiac surgery.
Austin Authors: Raman, Jai S ;Hata, Mitsumasa;Bellomo, Rinaldo ;Kohchi, K;Cheung, H L;Buxton, Brian F 
Affiliation: The Department of Cardiac Surgery, Austin & Repatriation Medical Centre, University of Melbourne, Melbourne, Australia
Issue Date: 1-Aug-2003
Publication information: The International Journal of Artificial Organs; 26(8): 753-7
Abstract: The role of hemofiltration (HF) during cardiopulmonary bypass (CPB) in adult cardiac surgery is controversial. It may be beneficial during prolonged CPB in high-risk surgery. Accordingly, we sought to compare two groups of patients undergoing high-risk cardiac surgery with or without HF.One hundred and eighteen patients who underwent complex cardiac surgical procedures during a 12-month period were divided into two groups. Group I (n=61) comprised patients who were treated with hemofiltration during CPB. Group II (n=57) were not filtered. Estimated risk of death, standard demographic, clinical and surgical features were obtained and predetermined outcomes were studied. Statistical comparisons were made.Age, procedure times and mortality rates were similar in both groups. The mean volume of fluid removed in group I was 3.4 L. The preoperative mean Parsonnet score was 24.8 in group I and 22.5 in group II (ns). Postoperative serum hemoglobin, hematocrit, platelet, and albumin levels were all significantly higher in group I patients (p=0.0015) indicating hemoconcentration. Post-operative chest drainage showed a trend toward decreased post-operative bleeding in group I (p=0.065). Postoperative pleural effusions requiring chest tube drainage were significantly less in group I (9.8% vs. 29.8% 6; p = 0.0062). The incidence of lung infection was also decreased from 26.3% to 13.1% (p=0.05). Operative mortality was similar in both groups (11.4% in group 1, 10.5% in group II, ns).Hemofiltration during CPB attenuates postoperative anemia, thrombocytopenia and hypoalbuminemia, may reduce post-operative bleeding and appears to decrease post-operative pulmonary complications.
Gov't Doc #: 14521173
Type: Journal Article
Subjects: Aged
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Middle Aged
Statistics, Nonparametric
Treatment Outcome
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