Issue |
J Extra Corpor Technol
Volume 16, Number 2, June 1984
|
|
---|---|---|
Page(s) | 68 - 72 | |
DOI | https://doi.org/10.1051/ject/198416268 | |
Published online | 13 September 2023 |
Proceedings
Ultrafiltration in Cardiac Surgery
1
Department of Cardiovascular Surgery, Stanford University School of Medicine, Stanford, CA
2
Division of Nephrology, Stanford University School of Medicine, Stanford, CA
* Direct communications to: B. Walpoth, M.D., Dept. of Cardiovascular Surgery, Stanford University Medical Center, Stanford, CA 94305.
Cardiopulmonary bypass (CPB) may result in hemodilution and volume overload. Restoration of a normal hematocrit is important for post-operative myocardial performance. Diuretics, conventionally used in the post-operative period may be ineffective due to renal impairment or lead to electrolyte imbalance.
Hollow-fiber hemofilters, made of an anisotropic polysulfone membrane (AMICON Diafilter) have been used for the ultrafiltration of blood in cardiac surgery during CPB. The hemofilter is inserted in the arterial line of the CPB. With this method ultrafiltration of the priming volume and restoration of the pre-operative hematocrit can be achieved and edema can be reversed.
In our experiments, performed in dogs (n = 5) we removed 1 L of an ultrafiltrate of plasma water in 15 minutes without hemodynamic changes or electrolyte imbalance. In the same time hematocrit increased from 19 to 29% (p < 0.05) and protein concentration from 2.7 to 5.4 g/dl (p < 0.05). Simultaneous studies with Crlabelled RBC’s demonstrated that blood volume was not significantly altered from pre CPB values during ultrafiltration, suggesting that the origin of the removed ultrafiltrate was mainly from the extravascular space.
© 1984 AMSECT
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