Effects of cardiopulmonary bypass and use of modified ultrafiltration

Background, Hemodilution is a prominent problem in cardiopulmonary bypass in a pediatric population. Ultrafiltration is a method used to reduce fluid volume and tissue edema and to increase hematocrit without the need for blood products. Modified ultrafiltration may offer advantages in comparison with conventional ultrafiltration. Methods. This article reviews the technique of modified ultrafiltration and its use, results, complications, and safety in pediatric cardiopulmonary bypass. Results. Modified ultrafiltration in pediatric cardiopulmonary bypass reduces total body water and serum levels of inflammatory mediators. It results in an elevated hematocrit without the need for transfusion, improved pulmonary compliance in the immediate postbypass period, and probably improved cerebral metabolic recovery after deep hypothermic circulatory arrest. Conclusions. Modified ultrafiltration can be performed safely in neonatal patients after cardiopulmonary bypass and offers advantages in comparison with conventional ultrafiltration. (C) 1998 by The Society of Thoracic Surgeons.