MODIFIED ULTRAFILTRATION: ROLE IN ADULT CARDIAC SURGICAL HAEMOSTASIS

Authors

  • Mahrukh Zahoor
  • Safdar Abbass
  • Asif Ali Khan
  • S. Afzal Ahmad

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 reducingpost operative bleeding. Methods: Aim of this study was to record the impact of modifiedultrafiltration on haemoconcentration and postoperative bleeding during adult cardiac surgery. Thisrandomized control trial included 100 patients, divided into 2 groups; MUF and control group. Serialblood samples were drawn to evaluate haematological indices. Postoperative chest drainage wasrecorded for 24 hours. Results were expressed in terms of percentages, means and p value (p<0.05 wastaken 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 washigher risk group (p=0.02) with longer extracorporeal perfusion time (p<0.001). Haemoconcentrationwas 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 transfusionrequirement (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, lowersblood loss and transfusion requirement after cardiac surgery in adult population.Key words: Modified ultrafiltration, haemoconcentration, haemostasis in cardiac surgery

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