ABSTRACT
Objective:
The aim of this study was to determine the effect of modified ultrafiltration (MUF) on interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-α) levels in pediatric patients with atrial, ventricular, and atrioventricular septal defects undergoing cardiopulmonary bypass (CPB).
Materials and Methods:
In the study, pediatric cases under 3 years of age, weighing less than 10 kg, with endocardial cushion defects scheduled for elective open heart surgery were randomly divided into two groups: MUF applied (group 1, n=17) and MUF not applied (group 2, n=17). All cases received ultrafiltration after CPB, and IL-6, IL-8, and TNF-α levels were compared at 24 h postoperatively. Demographic characteristics, hemodynamic and laboratory values, and clinical parameters during the 24-hours postoperative follow-up were recorded for all cases. data were analyzed using SPSS 22.0 software.
Results:
No statistically significant difference was observed in the comparison of IL-6, IL-8, and TNF-α levels between the groups.
Conclusion:
This study found that the application of MUF did not result in a significant difference in IL-6, IL-8, and TNF-α levels compared with patients without MUF. Further studies with similar designs are recommended to better evaluate the results.
Keywords:
Cardiopulmonary bypass, cytokine, modified ultrafiltration
References
1Paç M, Akçevin A, Aykut Aka S, Büket S, Sarıoğlu T. Kalp ve Damar Cerrahisi. 1. Cilt Baskı, Ankara:Özyurt Matbaacılık, 2004:1265-1275.
2McGiffin DC, Kirklin K. Cardiopulmonary Baypas for Cardiac Surgery. In: Sabiston DC Jr, Spencer FC (editors). 61h ed., Yol İİ, Philadelphia: WB Saunders, 1995:1256-1271.
3Boodhwani M, Hamilton A, de Varennes B, Mesana T, Williams K, Wells GA, et al. A multicenter randomized controlled trial to assess the feasibility of testing modified ultrafiltration as a blood conservation technology in cardiac surgery. J Thorac Cardiovasc Surg 2010;139(3):701-706.
4Yokoyama K, Takabayashi S, Komada T, Onoda K, Mitani Y, Iwata H, et al. Removal of prostaglandin E2 and increased intraoperative blood pressure during modified ultrafiltration in pediatric cardiac surgery. J Thorac Cardiovasc Surg 2009;137(3):730-735.
5Palanzo DA, Wise RK, Woitas KR, Ündar A, Clark JB, Myers JL. Safety and utility of modified ultrafiltration in pediatric cardiac surgery. Perfusion 2023;38(1):150-155.
6Bozdoğan D. Açık kalp cerrahisi uygulanan siyanotik/nonsiyanotik konjenital kalp hastalarında modifiye ultrafiltrasyonun postoperatif karaciğer ve böbrek fonksiyonları üzerine etkisi (Retrospektif çalışma). Tez, Ankara Üniversitesi Tıp Fakültesi Cebeci Eğitim ve Araştırma Hastanesi Kalp Merkezi, Ankara:2012.
7Bando K, Turrentine MW, Vijay P, Sharp TG, Sekine Y, Lalone BJ, et al. effect of modified ultrafiltration in high-risk patients undergoing operations for congenital heart disease. Ann Thorac Surg 1998;66(3):821-827.
8Sever K, Tansel T, Basaran M, Kafalı E, Ugurlucan M, Ali Sayin O, et al. The benefits of continuous ultrafiltration in pediatric cardiac surgery. Scand Cardiovasc J 2004;38(5):307-311.
9Birlikbaş E. Pediatrik Kalp Cerrahisinde Ultrafiltrasyonun Postoperatif Parametrelere Ve Böbrek Fonksiyonlarına Etkisi. Yüksek Lisans Tezi, İstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul:2020.
10Bart BA, Goldsmith SR, Lee KL, Givertz MM, O’Connor CM, Bull DA, et al. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J Med 2012;367(24):2296-2304.
11Journois D, Israel-Biet D, Pouard P, Rolland B, Silvester W, Vouhé P, et al. High-volume, zero-balanced hemofiltration to reduce delayed inflammatory response to cardiopulmonary baypass in children. Anesthesiology 1996;85(5):965-976.
12Draaisma AM, Hazekamp MG, Frank M, Anes N, Schoof PH, Huysmans HA. Modified ultrafiltration after cardiopulmonary bypass in pediatric cardiac surgery. Ann Thorac Surg 1997;64(2):521-525.
13Elliott M. Minimizing the bypass circuit: a rational step in the development of paediatric perfusion. Perfusion 1993;8(1):81-86.
14Kınoğlu B, Güden M, Kızıltan T, Özkara A, Köner Ö, Sarıoğlu T, ve ark. Yenidoğan ve İnfant Açık Kalp Cerrahisinde İntraoperatif Ultrafiltrasyon Uygulanması. GKD Cer Derg 1996;1:36-40.