Issue |
J Extra Corpor Technol
Volume 23, Number 3, September 1991
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|
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Page(s) | 140 - 151 | |
DOI | https://doi.org/10.1051/ject/1991233140 | |
Published online | 21 August 2023 |
Original Article
Comparing Ultrafiltration and Centrifugation During and After Pediatric Cardiopulmonary Bypass
The Department of Extracorporeal Circulation Technology, College of Health Related Professions, and the Division of Cardiothoracic Surgery, Medical University of South Carolina
* Address correspondence to: Laura J. Traynor, Medical University of South Carolina, CHRP, ECT, 171 Ashley Avenue, Charleston, South Carolina 29425-2701
Blood processing techniques related to pediatric cases have previously been generalized from adult experiences.
Twenty-two pediatric patients (<25 kilograms) undergoing cardiopulmonary bypass (CPB) for various congenital defects were prospectively randomized into an ultrafiltration or centrifugation group. Sixty-one variables were compared.
The blood infused from the ultrafiltration technique contained significantly more heparin (p=0.0001) and more plasma-free hemoglobin (PFH) (p=0.0001) levels than the centrifugation blood. Centrifugation patients had a significantly higher hematocrit (p=0.0066) than the ultrafiltration group twenty minutes postoperatively. The ultrafiltration patients (mean=431.82cc±116.8) received less total packed red blood cell volume before and during bypass than the centrifugation group (mean=534.091cc±113.07). In the centrifugation group, wash volumes showed positive correlation to postoperative blood sodium levels (r= +0.4006, p< 0.05). No significant difference was found between postoperative and preoperative sodium levels (p> 0.05). PFH levels for both groups showed a significant positive correlation to postoperative creatinine levels (r= +.4029, p< 0.05) suggesting decreased postoperative renal function, but a significant negative correlation to post-bypass hematocrit (r= -.4548, p< 0.05). Post-bypass heparin levels in the circuit showed a significant positive correlation to heparin levels in the reinfusion blood for the ultrafiltration group (r= +.8025, p<0.05). Post-bypass PFH level in the circuit showed a significant positive correlation to PFH levels in the reinfusion blood for both groups (r= +.5339, p<0.05). No significant difference existed between the ultrafiltration and centrifugation groups for postoperative prothrombin and partial thromboplastin times.
For pediatric cases, the centrifugation technique was found to be superior for post-bypass blood processing based on a higher postoperative patient hematocrit and the presence of less heparin and less PFH in the reinfused blood. The ultrafiltration technique was found to be superior for intraoperative blood processing due to a lower total packed red cell volume addition before and during bypass.
Key words: ultrafiltration / centrifugation / blood processing / pediatrics
© 1991 AMSECT
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