Ultrafiltration in Cardiac Surgery

Searles, Bruce; Darling, Edward

doi:10.1007/978-1-59745-305-9_9

Cited by 2 publications

(8 citation statements)

References 60 publications

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“…All of these techniques share a common goal: blood concentration, filtration, and the balancing of shifts in the electrolyte plasma concentration as potassium overload, thus protecting the kidney and avoiding homologous blood transfusions. 4,5 Some studies suggest that the use of UF during CPB to remove excessive fluid is not renal protective and may even lead to kidney damage if the fluid removed is more than what is needed. 3 Furthermore, recent reviews warn that we should limit UF in patients with reduced kidney function to prevent AKI.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Some studies suggest that the use of UF during CPB to remove excessive fluid is not renal protective and may even lead to kidney damage if the fluid removed is more than what is needed. 3 Furthermore, recent reviews warn that we should limit UF in patients with reduced kidney function to prevent AKI. 4 Some studies have set a limit to the volume of ultrafiltrate removed above which AKI can occur to 2900 ml (knowing that 2200 ml is equivalent = 32 ml/kg in an average 70 kg adult).…”

Section: Introductionmentioning

confidence: 99%

“…3 Furthermore, recent reviews warn that we should limit UF in patients with reduced kidney function to prevent AKI. 4 Some studies have set a limit to the volume of ultrafiltrate removed above which AKI can occur to 2900 ml (knowing that 2200 ml is equivalent = 32 ml/kg in an average 70 kg adult). 5 The aim of our present study is to investigate if ultrafiltration is associated with an increased risk of AKI and the safety of its use in patients with previous kidney problems.…”

Section: Introductionmentioning

confidence: 99%

“…Ultrafiltration (UF) is a technique commonly used during CPB for volume management and/or filtration of blood to reduce deleterious components. 3 An ultrafilter can be incorporated into a CPB circuit and plasma water, and its soluble components are removed as blood passes through the ultrafilter fibers. Common UF techniques include modified ultrafiltration (MUF), conventional ultrafiltration (CUF), and zero‐balanced ultrafiltration (ZBUF).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrafiltration and cardiopulmonary bypass associated acute kidney injury: A systematic review and meta‐analysis

Kandil

Motawea

Darling

et al. 2021

Clinical Cardiology

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Background: Cardiopulmonary bypass is known to raise the risk of acute kidney injury (AKI). Previous studies have identified numerous risk factors of cardiopulmonary bypass including the possible impact of perioperative ultrafiltration.However, the association between ultrafiltration (UF) and AKI remains conflicting.Thus, we conducted a meta-analysis to further examine the relationship between UF and AKI.Hypothesis: Ultrafiltration during cardiac surgery increases the risk of developping Acute kidney Injury.Methods: We searched PubMed, Web of Science, EBSCO, and SCOPUS through July 2021. The RevMan (version 5.4) software was used to calculate the pooled risk ratios (RRs) and mean differences along with their associated confidence intervals (95% CI). Results:We identified 12 studies with a total of 8005 patients. There was no statistically significant difference in the incidence of AKI between the group who underwent UF and the control group who did not (RR = 0.90, 95% CI = 0.64−1). Subgroup analysis on patients with previous renal insufficiency also yielded nonsignificant difference (RR = 0.84, 95% CI = 0.53 −1.33, p = .47). Subgroup analysis based on volume of ultrafiltrate removed (> or <2900 ml) was not significant and did not increase the AKI risk as predicted (RR = 0.82, 95% CI = 0.63 −1.07, p = .15). We also did subgroup analysis according to the type of UF and again no significant difference in AKI incidence between UF groups and controls was observed in either the conventional ultrafiltration (CUF), modified ultrafiltration (MUF), zero-balanced ultrafiltration (ZBUF), or combined MUF and CUF subgroups. Conclusion:UF in cardiac surgery is not associated with increased AKI incidence and may be safely used even in baseline chronic injury patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ultrafiltration and cardiopulmonary bypass associated acute kidney injury: A systematic review and meta‐analysis

Kandil

Motawea

Darling

et al. 2021

Clinical Cardiology

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The role of NRF-2 in renal damage in cardiopulmonary bypass

2023

Eu Clin Anal Med

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Cardiopulmonary bypass, which allows cardiac interventions, is a standard perfusion technique used in cardiac surgery, which provides cardiac arrest by using cardioplegic solutions and oxygenates the blood outside the body through extracorporeal circulation and redirects blood back to the patient. With the use of cardiopulmonary bypass technique, serious complications may develop in the perioperative and postoperative periods. One of the most important of these developing complications is kidney damage. New biomarkers that will enable the early detection of this developing kidney damage are being investigated, one of which is NRF-2. Our aim in this review article is to investigate current information about NRF-2 and to identify the role factors associated with kidney damage.

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Ultrafiltration in Cardiac Surgery

Cited by 2 publications

References 60 publications

Ultrafiltration and cardiopulmonary bypass associated acute kidney injury: A systematic review and meta‐analysis

Ultrafiltration and cardiopulmonary bypass associated acute kidney injury: A systematic review and meta‐analysis

The role of NRF-2 in renal damage in cardiopulmonary bypass

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