The effect of ultrafiltration on end-cardiopulmonary bypass hematocrit during cardiac surgery

Mongero, Linda B.; Stammers, Alfred H.; Tesdahl, Eric A.; Stasko, Andrew; Weinstein, Samuel

doi:10.1177/0267659117747046

Cited by 27 publications

(21 citation statements)

References 13 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The field of medicine is the lowest observed area of research found in this review. However, medicine has a higher research input in other membrane-based processes such as ultrafiltration where the membrane pore diameter is more appropriate for effective removal of certain contaminants [24] and hemoconcentration during cardiopulmonary bypasses [25].…”

Section: General Research Trends Since 2009mentioning

confidence: 99%

Microfiltration membrane processes: A review of research trends over the past decade

Anis

Hashaikeh

Hilal

2019

Journal of Water Process Engineering

146

View full text Add to dashboard Cite

Since its inception in the 19 th century, microfiltration (MF) has evolved as a membrane-based separation technology for treating various effluents and wastewaters. This review aims to familiarize its readers with general and specific research trends on various topics in MF. The level of research interest has been measured by the number of publications in that area for each year. An increasing research trend was observed from the number of publications since 2009 to 2018 with MF as the major topic. During the past decade, MF articles have spanned in about 150 different journals, with The Journal of Membrane Science, Desalination and Separation and Purification Technology being the major ones. Major topics of interest include membrane fabrication and modification, waste water treatment and fouling studies, while a significant research increase was seen in various fabrication methods and MF application in the food sector. MF modeling still remains a topic which needs further research output, and has experienced a decline over the past years. Several potential research areas are also identified in this review which will help future researchers to materialize their efforts into the right direction.

show abstract

Section: General Research Trends Since 2009mentioning

confidence: 99%

Microfiltration membrane processes: A review of research trends over the past decade

Anis

Hashaikeh

Hilal

2019

Journal of Water Process Engineering

146

View full text Add to dashboard Cite

show abstract

“…We have previously shown that the use of ULF during CPB does increase end-Hct levels with the greatest benefit seen when ULV volumes were under 2,500 mL. 23 More recently, however, we have questioned the use of ULF as a means of reducing RBC transfusion even after 1,300 mL of plasma water removed. 24 Most of the studies that have demonstrated an effect of ULF on RBC transfusion have combined ULF with other blood management techniques.…”

Section: Discussionmentioning

confidence: 99%

The effect of various blood management strategies on intraoperative red blood cell transfusion in first-time coronary artery bypass graft patients

Stammers¹,

Tesdahl²,

Mongero³

et al. 2019

Perfusion

Self Cite

View full text Add to dashboard Cite

Effective blood management during cardiac surgery requires a multifactorial effort to limit exposure to allogeneic blood products. The present study evaluated the distribution of intraoperative interventions in patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass. Records from patients undergoing non-reoperative surgery at 120 hospitals between January 2017 and December 2017 were reviewed, and red blood cell transfusion quartiles established. The 31 hospitals with the lowest transfusion rates fell into the first quartile (low transfusion group, n = 3,186 patients), while 29 hospitals with the highest transfusion were in the fourth quartile (high transfusion group, n = 2,561). A survey was sent to assess the blood management techniques: acute normovolemic hemodilution, autologous prime, fluid management, intraoperative autotransfusion, ultrafiltration, and transfusion triggers. All data are presented as mean (standard deviation). Patients in the low transfusion group had red blood cell transfusion rate of 5.5%, while the high transfusion group was 28.3%. There was no difference in gender or age. Fluid management was reduced in the low transfusion group with smaller prime volumes and anesthesia volumes, but higher crystalloid use during cardiopulmonary bypass. The low transfusion group did not use acute normovolemic hemodilution as often and had lower sequestered volumes when used. When ultrafiltration was used, the low transfusion quartile group removed more volume (1,555.9 ± 955.2 vs. 1,326.1 ± 918.9 mL, p ⩽ 0.001). In the low transfusion group, nadir hematocrit on–cardiopulmonary bypass averaged 1.6% lower and 3.0% lower for transfusion post–cardiopulmonary bypass. Intraoperative red blood cell units averaged 0.11 ± 0.50 U in low transfusion group compared to 0.63 ± 1.14 U in the high transfusion group. Mixed-effects logistic regression identified first in operating room and first on cardiopulmonary bypass hematocrit, estimated blood volume and nadir hematocrit transfusion trigger as the strongest predictors for red blood cell transfusion. Significant variation exists in the transfusion of red blood cell in coronary artery bypass graft patients undergoing cardiopulmonary bypass which may be related to the application of intraoperative blood management techniques.

show abstract

“…Cardiac surgery remains one of the greatest consumers of blood products. Despite the studies those report the benefit of ultrafiltration, it is used less frequently in adult cardiac surgery [34]. Boodhwani et al reported significant decrease in surgical blood loss by using ultrafiltration in the metaanalysis of 11 articles.…”

Section: Discussionmentioning

confidence: 99%

Use of Conventional Ultrafiltration in Patients with Pulmonary Hypertensive Mitral Valve Disease Undergoing Valve Surgery

Depboylu¹,

Yazman²,

Harmandar³

2018

CCR

View full text Add to dashboard Cite

Adverse effects of cardiopulmonary bypass on blood and lungs are encountered more severelyin pulmonary hypertensive patients undergoing mitral valve surgery. Aim of this study is to identify the favorable effects of conventional ultrafiltration on postoperative pulmonary functions, hemodynamics, morbidity or mortality in pulmonary hypertensive patients undergoing mitral valve surgery. 40 patients with severe pulmonary hypertension who underwent mitral valve surgery were included in study. Patients were divided into two groups according to whether conventional ultrafiltration was applied or not. Demographic data, preoperative transthoracic echocardiography, respiratory functions, complete blood count, biochemical parameters, alterations in pulmonary functions, bleeding, use of inotropic agents and blood products, intubation time, mortality, morbidity, length of intensive care unit and hospital stay, were evaluated. Intubation time (7.97±2.77 vs. 10.12±2.95; p<0.05), intensive care stay (42.20±65.99 vs. 44.25±14.13; p<0.05), hospital stay (7.20±1.13 vs. 10.12±3.27; p<0.05), bleeding (370.00±216.28 vs. 506.25±247.03; p<0.05) were significantly shorter in study group. Use of blood products (4.20±1.23 vs. 4.90±2.13; p>0.05) and inotropic agents (14 vs. 18; p>0.05) were less than the control group. Increase of pulmonary compliance, cardiac index, oxygen index, decrease of alveolar-arterial oxygen pressure difference and ventilation index were significant in both groups. Hematocrit (28.07±3.18 vs. 26.96±2.51; p>0.05) and white blood cell (13.56±2.37 vs. 13.03±2.51; p>0.05) were higher in the study. No morbidity and mortality were presentin both groups. Conventional ultrafiltration decreased the intubation time, intensive care unit stay, hospital stay, bleeding, use of blood products and inotropic agents. Favorable effects were also detected on pulmonary compliance, cardiac index, oxygen index, alveolar-arterial oxygen pressure difference and ventilation index. Studies with larger patient population, application of conventional and modified ultrafiltration together may give significant results for pulmonary functions.

show abstract

The effect of ultrafiltration on end-cardiopulmonary bypass hematocrit during cardiac surgery

Cited by 27 publications

References 13 publications

Microfiltration membrane processes: A review of research trends over the past decade

Microfiltration membrane processes: A review of research trends over the past decade

The effect of various blood management strategies on intraoperative red blood cell transfusion in first-time coronary artery bypass graft patients

Use of Conventional Ultrafiltration in Patients with Pulmonary Hypertensive Mitral Valve Disease Undergoing Valve Surgery

Contact Info

Product

Resources

About