Technique

Veno-Arterial Modified Ultrafiltration in Children after Cardiopulmonary Bypass

Departments of Cardiothoracic Surgery and Anesthesia, Hasbro Children’s Hospital, Providence, Rhode Island

^* Address correspondence to: Bryan J. Buchholz, CCP Lead Pediatric Perfusionist Pediatric Hospital Office 593 Eddy Street APC 1 04 Providence, Rl 02903

Abstract

A method of performing veno-arterial modified ultrafiltration is described that utilizes conventional blood flow through the aortic and venous cannulae. A dual-pump blood cardioplegia console is adapted to aspirate blood from the cardiopulmonary bypass venous line. The blood is ultrafiltered, sent through the cardioplegia heat exchanger, and returned to the aorta via the cardioplegia needle.

Veno-arterial modified ultrafiltration has produced no visual evidence of air entrainment in the cardiopulmonary arterial line. This method allows the immediate resumption of cardiopulmonary bypass without the need for the surgeon to recannulate or alter tubing. Thirty-five children underwent veno-arterial modified ultrafiltration; the results show significant increases in postoperative hematocrit, early extubation, and improved rheology.