MODIFIED ULTRAFILTRATION: ROLE IN ADULT CARDIAC SURGICAL HAEMOSTASIS
Abstract
Background: During cardiac surgery, cardiopulmonary bypass (CPB) leads to haemodilutionalanaemia and activation of inflammatory mediators, affecting haemostasis. Modified Ultrafiltration
(MUF) is being increasingly favoured for haemoconcentration without blood transfusion and reducing
post operative bleeding. Methods: Aim of this study was to record the impact of modified
ultrafiltration on haemoconcentration and postoperative bleeding during adult cardiac surgery. This
randomized control trial included 100 patients, divided into 2 groups; MUF and control group. Serial
blood samples were drawn to evaluate haematological indices. Postoperative chest drainage was
recorded for 24 hours. Results were expressed in terms of percentages, means and p value (p<0.05 was
taken as significant). Results: Four patients were excluded and 96 patients were analyzed (MUF n=50,
control n=46). According to American society of anaesthetist (ASA) classification, MUF group was
higher risk group (p=0.02) with longer extracorporeal perfusion time (p<0.001). Haemoconcentration
was successfully achieved in MUF group (final haemoglobin=10.7±1.25, haematocrit=33±3.64%,
p<0.001) with lower blood loss (MUF=395±153 ml, control=755±435 ml, p<0.001) and transfusion
requirement (p<0.001). Re-exploration rate was 4% and 6.5% in MUF and control group respectively
(p=0.57). Mortality in both groups was comparable (MUF=4%, control=4.3%, p=0.94). Conclusions:
Modified ultrafiltration is a safe procedure which successfully achieves haemoconcentration, lowers
blood loss and transfusion requirement after cardiac surgery in adult population.
Key words: Modified ultrafiltration, haemoconcentration, haemostasis in cardiac surgery
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