Issn Print: 1058-2916

Publication Date: 2000/03/01


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ANALYSIS OF THE EFFECT OF MODIFIED ULTRAFILTRATION AFTER CARDIOPULMONARY BYPASS FOR PEDIATRIC OPEN HEART SURGERY

H. Suhara; S. Ohtake; Y. Sawa; N. Fukushima; M. Nishimura; H. Ichikawa; G. Matsumiya; K. Kagisaki; H. Matsuda

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Excerpt

Modified ultrafiltration (MUF) has been widely employed in pediatric open heart surgery since Elliott's report in 1991. Although MUF is known to be useful to stabilize the hemodynamics after cardiopulmonary bypass by concentration of the circulatory blood, it is still controversial whether inflammatory chemical mediators, such as cytokines and chemokines, are removed by MUF. In this study, the ability of MUF to remove inflammatory cytokines was evaluated. MUF was performed about 10 minutes at the end point of cardiopulmonary bypass and blood was sampled before and after MUF and the inflow and the outflow of the hemoconcentrator. Granular elastase and inflammatory cytokines, IL-6 and IL-8 were measured.
□Results□ Clinical courses after open heart surgery are imprvoed by MUF apparently. There were no significant changes in serum levels of grannular elastase, IL-6 and IL-8 neither before nor after MUF. There were no significant differences between the inflow and the outflow of the hemoconcentrators. In some cases, those parameters even increased adversely after MUF or at the outflow of the hemoconcentrator. From these results, it is suggested that the cytokine removal ability of MUF is not consistent, and that the beneficial effect of MUF is not due to removal of cytokine. □Conclusion□ The beneficial effect of MUF is considered mainly due to the hemoconcentration, but not due to the cytokine removal ability, although other inflammatory chemical mediators are not determined.

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