Effect of modified ultrafiltration on the inflammatory response in paediatric open-heart surgery: a prospective, randomized study
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Effect of modified ultrafiltration on the inflammatory response in paediatric open-heart surgery : a prospective, randomized study. / Chew, Michelle S; Brix-Christensen, Vibeke; Ravn, Hanne B; Brandslund, Ivan; Ditlevsen, Emmy; Pedersen, Jens; Hjortholm, Kirsten; Tønnesen, Else; Hjortdal, Vibeke E; Hansen, Ole Kromann.
In: Perfusion, Vol. 17, No. 5, 09.2002, p. 327-33.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effect of modified ultrafiltration on the inflammatory response in paediatric open-heart surgery
T2 - a prospective, randomized study
AU - Chew, Michelle S
AU - Brix-Christensen, Vibeke
AU - Ravn, Hanne B
AU - Brandslund, Ivan
AU - Ditlevsen, Emmy
AU - Pedersen, Jens
AU - Hjortholm, Kirsten
AU - Tønnesen, Else
AU - Hjortdal, Vibeke E
AU - Hansen, Ole Kromann
PY - 2002/9
Y1 - 2002/9
N2 - Modified ultrafiltration (MUF) is often used in conjunction with paediatric cardiac surgery with cardiopulmonary bypass (CPB) and is thought to improve clinical outcome. It is unclear whether these improvements (if any) are due to the removal of inflammatory mediators. In this prospective study, 18 children aged 12-24 months undergoing uncomplicated cardiac surgery with methylprednisolone added in the pump prime were randomized to receive CPB with (n = 10) and without (n = 8) MUF. Cytokines (TNFalpha, IL-6, IL-1beta, IL-10, IL-1ra), complement split products (C3d, C4d) and coagulation system activation (F1 + 2, ATIII) were measured pre-, peri- and up to 48 h postoperatively. For clinical outcome, the alveolar-arterial oxygen (A-a) gradient, transfusion requirement, drain loss, mean blood pressure and requirement for inotropic support were registered up to 24 h postoperatively. Our results show an improvement in postoperative oxygenation as well as a tendency towards decreased drain loss and improved haemodynamics in the MUF group. There were no intergroup differences detectable for TNFalpha, IL-1beta, IL-1ra, complement and coagulation markers. We conclude that MUF in itself does not significantly influence TNFalpha, IL-1beta, IL-1ra and the complement and coagulation profiles in children undergoing cardiac surgery with CPB. Despite this, there was some evidence for improved clinical outcome. Our results do not support that MUF improves postoperative organ function by modulation of the measured markers of inflammation.
AB - Modified ultrafiltration (MUF) is often used in conjunction with paediatric cardiac surgery with cardiopulmonary bypass (CPB) and is thought to improve clinical outcome. It is unclear whether these improvements (if any) are due to the removal of inflammatory mediators. In this prospective study, 18 children aged 12-24 months undergoing uncomplicated cardiac surgery with methylprednisolone added in the pump prime were randomized to receive CPB with (n = 10) and without (n = 8) MUF. Cytokines (TNFalpha, IL-6, IL-1beta, IL-10, IL-1ra), complement split products (C3d, C4d) and coagulation system activation (F1 + 2, ATIII) were measured pre-, peri- and up to 48 h postoperatively. For clinical outcome, the alveolar-arterial oxygen (A-a) gradient, transfusion requirement, drain loss, mean blood pressure and requirement for inotropic support were registered up to 24 h postoperatively. Our results show an improvement in postoperative oxygenation as well as a tendency towards decreased drain loss and improved haemodynamics in the MUF group. There were no intergroup differences detectable for TNFalpha, IL-1beta, IL-1ra, complement and coagulation markers. We conclude that MUF in itself does not significantly influence TNFalpha, IL-1beta, IL-1ra and the complement and coagulation profiles in children undergoing cardiac surgery with CPB. Despite this, there was some evidence for improved clinical outcome. Our results do not support that MUF improves postoperative organ function by modulation of the measured markers of inflammation.
KW - Biomarkers/blood
KW - Blood Coagulation
KW - Cardiac Surgical Procedures/methods
KW - Cardiopulmonary Bypass/adverse effects
KW - Child, Preschool
KW - Complement System Proteins/analysis
KW - Cytokines/blood
KW - Hemofiltration
KW - Humans
KW - Infant
KW - Inflammation/blood
KW - Methylprednisolone/administration & dosage
KW - Prospective Studies
KW - Treatment Outcome
U2 - 10.1191/0267659102pf595oa
DO - 10.1191/0267659102pf595oa
M3 - Journal article
C2 - 12243435
VL - 17
SP - 327
EP - 333
JO - Perfusion (United Kingdom)
JF - Perfusion (United Kingdom)
SN - 0267-6591
IS - 5
ER -
ID: 243519699