Successful aortic valve replacement using dilutional ultrafiltration during cardiopulmonary bypass in a patient with Child-Pugh class C cirrhosis

Iino, Kenji; Tomita, Shigeyuki; Yamaguchi, Shohjiro; Watanabe, Go

doi:10.1510/icvts.2007.166843

Cited by 11 publications

(3 citation statements)

References 8 publications

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“…Because a hemofilter is mainly used for concentration of blood, due to its filtration functions, blood circulates into a hemofilter over a prolonged duration during extracorporeal circulation. 20 Furthermore, a hemofilter is used for various perfusion techniques such as modified ultrafiltration, 21 dilutional ultrafiltration, 22 zero-balance ultrafiltration, 23 or any other hemopurification method. 24,25 These techniques also require blood circulation into a hemofilter for prolonged duration.…”

Section: Discussionmentioning

confidence: 99%

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

et al. 2018

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Objective:Extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPCA) that has a hydrophilic blood-contacting layer, but hemofilters are not. We aimed to investigate the antithrombotic properties of a BPCA-coated hemofilter.Methods:Four experiments using BPCA-coated circuits and non-coated hemofilters and four experiments using BPCA-coated circuits and BPCA-coated hemofilters were performed with whole human blood and compared by measuring the circuit pressure every 5 min, antithrombin activity every 40 min, and thrombin–antithrombin complex every 40 min, for a total of 240 min of recirculation.Results:The mean time required for the pressure at the inlet of the hemofilter to increase sharply was longer in BPCA-coated than in non-coated hemofilters (66 ± 11 min vs 25 ± 9 min, p < 0.01). The mean antithrombin activity value at 200 and 240 min of recirculation was significantly higher in the experiments with BPCA-coated versus non-coated hemofilters (43.3 ± 2.87 vs 33.3 ± 5.74, p = 0.04; 42.8 ± 3.59 vs 31.0 ± 5.35, p = 0.01, respectively); the antithrombin activity values at the other time points were not significantly different. Furthermore, all thrombin–antithrombin complex values in experiments with the BPCA-coated hemofilters achieved overrange at 80 min of recirculation, whereas those with the non-coated hemofilter achieved overrange at 40 min.Conclusion:This study suggests that BPCA-coated hemofilters can inhibit antithrombin consumption, contributing to antithrombotic effects in extracorporeal circulation circuits.

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Section: Discussionmentioning

confidence: 99%

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

et al. 2018

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“…The dotted lines are the regression lines for the polymer-coated haemoconcentrators. R 2 is the coefficient of determination.…”

Section: Resultsmentioning

confidence: 99%

“…In an extracorporeal circulation circuit used in a cardiopulmonary bypass surgery, a haemoconcentrator, which is composed of a hollow fibre consisting of plastic materials such as polysulfone or polyethersulfone, filtrates blood components smaller than albumin, thus concentrating blood (1). Haemoconcentrators have also been used in perfusion techniques such as dilutional ultrafiltration, modified ultrafiltration, and zero-balance ultrafiltration for haemocatharsis in cardiopulmonary bypass surgeries (2–7). To perform these roles, a haemoconcentrator is required to be in contact blood for long periods of time and thus must be biocompatible.…”

Section: Introductionmentioning

confidence: 99%

Prospects for Clinical Applications of Polymer-Coated Haemoconcentrator on Extracorporeal Circuit in Cardiopulmonary Bypass Surgeries

et al. 2016

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Purpose Extracorporeal circulation circuits used in cardiopulmonary bypass surgeries are increasingly being coated with polymer materials to reduce the thrombogenicity of extracorporeal devices. However, a haemoconcentrator, which corrects haematocrit and electrolyte imbalances, is not coated with polymers. In this study, we sought to assess the filtration performance of polymer-coated haemoconcentrators in order to obtain insight into their prospects for use in clinical applications. Methods In vitro experiments were performed to evaluate the water pressure and flow properties of polymer-coated haemoconcentrators by comparing 3 polymer-coated haemoconcentrators with 3 non-coated haemoconcentrators. The cross-sectional surfaces of both types of haemoconcentrators were observed using a scanning electron microscope (SEM). Results The slopes of the regression lines for estimating the filtrated fluid flow as a function of the transmembrane pressure were 6.286 ± 0.320 for polymer-coated haemoconcentrators and 3.712 ± 0.170 for non-coated haemoconcentrators. These slopes were found to be significantly different and indicate that the filtration velocity is enhanced in polymer-coated haemoconcentrators over that in non-coated haemoconcentrators. However, the hollow fibre damage observed by SEM was not shown to contribute to higher filtration flow in the polymer-coated haemoconcentrator. Taking these results into consideration, we hypothesise that a polymer coating makes a foreign surface on a hollow fibre slippery, owing to the hydrophobicity of the polymer, thereby enhancing the velocity of the filtration. Conclusions The results of this preliminary investigation suggest that a polymer coating can enhance the filtration performance of a haemoconcentrator and that polymer-coated haemoconcentrators might be useful in clinical applications.

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The Patient with Severe Comorbidities: Cardiac Disease

Shayan

Wolf

2012

Liver Anesthesiology and Critical Care Medicine

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Successful aortic valve replacement using dilutional ultrafiltration during cardiopulmonary bypass in a patient with Child-Pugh class C cirrhosis

Cited by 11 publications

References 8 publications

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

Antithrombotic properties of hemofilter coated with polymer having a hydrophilic blood-contacting layer

Prospects for Clinical Applications of Polymer-Coated Haemoconcentrator on Extracorporeal Circuit in Cardiopulmonary Bypass Surgeries

The Patient with Severe Comorbidities: Cardiac Disease

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