González VAB

Language: Spanish
References: 7
Page: 111-114
PDF size: 67.03 Kb.

ABSTRACT

Children undergoing extracorporeal circulation, along with moderate to profound hypothermia and hemodilution are associated with disturbance of the capillary permeability. This increase in vascular permeability in mainly due to the extracorporeal circulation. The accumulation of extravascular fluid secondary to capillary leakage can lead to multiple organ failure, particularly in low weight patients. Modified ultrafiltration is a method employed, specially in children, with advantages such as revert hemodilution, remove some inflammatory mediators, improve cardiac index, decrease water accumulation, postoperative blood transfusions and systemic vascular resistance. The technique consists in ultrafiltrating the patient just at the end of the extracorporeal circulation until obtaining the desired hematocrit, regulating in this way the severity of the postoperative edema.

REFERENCES

1. Gravlee GP, Roger AM. Cardiopulmonary bypass principles and practice hemofiltration, dyalisis and blood salvage techniques during cardiopulmonary bypass. 2ª. Ed. Williams and Wilkins Philadelphia 2000: 105-112.

2. Jonas R, Naik S, Elliott M. Cardiopulmonary bypass in neonates, infants and young children, filtration in pediatric cardiac surgery. Butterworth-Heinemann Ltd. Great Britain 1994: 158-170.

3. Traynor L, Sutton R. Comparing ultrafiltration and centrifugation during after pediatric cardiopulmonary bypass. JECT 1992; USA 23 (3) 140-151.

4. Gaynor JW, Tulloh RM. Modified ultrafiltration reduces myocardial edema and reverses hemodilution following cardiopulmonary bypass in children. J AM Coll Cardiol 1995; USA 25: 200.

5. Gerard JM, Richard BL. Cardiovascular perfusion services and pediatric cardiovascular surgery “simple modified ultrafiltration” perfusion Arnold 2000; USA 15(5): 447-452.

6. Naik SK. A prospective randomized study of a modified technique of ultrafiltration during pediatric open-heart surgery. Circulation 1991; USA (Suppl III). 422-431.

7. Naik S, Elliott M. A successful modification of ultrafiltration for cardiopulmonary bypass in children. Perfusion 1991; USA 6: 41-50.