Effect Of Different Balanced Ultrafiltration Volume On Inflammatory Mediators During Cardiopulmonary Bypass

ObjectiveIn process of cardiopulmonary bypass (CPB), the contact of blood and CPB tube, myocardial ischemia and reperfusion injury, low blood pressure activate the complement, neutrophils, platelets and vascular endothelial cells, which can cause systemic inflammation, leading to systemic inflammatory response syndrome (SIRS). SIRS represents as damage of lung and kidney functiond, and even multiple organ failure (MSOF).It is reported that balanced ultrafiltration can reduce concentration of serum inflammatory mediators after CPB. But now in various medical centers around the world, there is not a unified standard for the volume of balanced ultrafiltration during CPB. The study compared the effect of the different volume of balanced ultrafiltration on concentration of serum inflammatory mediators in infants CPB, to explore a more reasonable strategy of balanced ultrafiltration.Methods80 children with congenital heart disease were randomly divided into 4 groups, control group (group C), low ultrafiltrate volume(UFV) group [group L, UFV=30mL/(kg·h)], moderate UFV group [group M, UFV=60mL/(kg·h)], high UFV group [group H, UFV=90mL/(kg·h)], all of the groups were given modified ultrafiltration after termination of cardiopulmonary bypass(CPB). Serum TNF-a, IL-6, IL-8 were measured at the beginning and termination of CPB,2 hours and 12 hours postoperatively.ResultsDuring CPB, the concentrations of TNF-α, IL-6 and IL-8 increased significantly in group C and didn’t change so significantly in trial groups. As compared among the trial groups, concentrations of TNF-a, IL-6 and IL-8 in group L were higher than group M and H (p<0.05); difference of concentrations of TNF-a, IL-6 and IL-8 between group M and H didn’t reach statistical significance.ConclusionThe study showed that function of BUF to remove inflammatory mediators increased with the UFV enhancing, when UFV<30mL//(kg-h), the effect is weak, and effect of UFV=90mL/(kg·h) didn’t increase significantly as compared with UFV=60mL/(kg·h). So UFV=60mL/(kg·h) is a more reasonable BUF strategy. Objective To evaluate the effect of different balancedd ultrafiltration(BUF) volume on inflammatory mediators in children underwent open-heart surgery. Methods 80 children with congenital heart disease were randomly divided into 4 groups, control group (groupC),low ultrafiltrate volume(UFV) group[group L, UFV=30mL/(kg·h)],moderate UFV group [group M, UFV= 60 mL/(kg·h)], high UFV group [group H, UFV=90mL/(kg·h)], all of the groups wre given modified ultrafiltration after termination of cardiopulmonary bypass(CPB). Serum TNF-a, IL-6, IL-8 were measured at the beginning and termination of CPB,2 hours and 12 hours postoperatively. Results During CPB, the concentrations of TNF-a, IL-6 and IL-8 increased significantly in group C and didn’t change so significantly in trial groups. As compared among the trial groups, concentrations of TNF-a, IL-6 and IL-8 in group L were higher than group M and H (p<0.05); difference of concentrations of TNF-a, IL-6 and IL-8 between group M and H didn’t reach statistical significance. Conclusion The study showed that function of BUF to remove inflammatory mediators increased with the UFV enhancing, when UFV<30mL//(kg-h), the effect is weak, and effect of UFV=90mL/(kg·h) didn’t increase significantly as compared with UFV=60mL/(kg·h). So UFV 60mL/(kg·h) is a more reasonable BUF strategy.