Combined Ultrafiltration During And Afer Cardiopulmonary Bypass In Children:effects On Cytokines And Cell Adhesion Molecules

Objective Cardiac surgery with cardiopulmonary bypass(CPB) results in release of cytokines and expression of adhesion molecules(AM) with subsequent inflammatory response. The purpose of the study was to investigate the changes of soluble cytokines and cell adhesion molecules perioperatively and to evaluate the clinical impact of combined ultrafiltration and its efficacy in reducing cytokines and cell adhesion molecules following CPB in children. Method Nineteen children with congenital heart disease were prospectively randomized into a control group(n=1O) and a group who underwent combined ultrafiltration(n=9). WBC and PMN count, HCT, HGB, interleukin-6, interleukin-8, ICAM-1 ,VCAM-1, lung compliance, airway peak pressure and plateau pressure were assessed perioperatively. Compare Pa02, PaCO2 at the end of CPB and the chest tube drainage 24h after surgery, duration of ventilation, time spent in the intensive care unit between the two groups. Results 1 .WBC and PMN count elevated obviously after CPB, and there were no significant differences between the two groups (P>O.05). After combined ultrafiltration, HCT and HGB rose from 21.9 3.1(%),68 9(G/L) to 28.5 2.O(%), 91 5(01) respectively (P