Aggarwal Naresh Kumar, Das Sambhu Nath, Sharma Gautam, Kiran Usha
Departments of Cardiac Anaesthesia and Cardiology Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi.
Ann Card Anaesth. 2007 Jan;10(1):27-33. doi: 10.4103/0971-9784.37921.
Thirty children undergoing cardiac surgery under cardiopulmonary bypass (CPB) were prospectively studied to assess beneficial effects of modified ultrafiltration (MUF) over and above conventional ultrafiltration (CUF). Transoesophaegeal echocardiography determined ejection fraction (EF), fractional area change (FAC) and posterior wall thickness in end-diastole and end-systole were measured and compared in two groups undergoing CUF (group I) and CUF plus MUF (group II). Haemodynamic data, haematocrit, temperature drift, postoperative chest tube drainage in first 48 hours, ventilation and intensive care unit (ICU) stay were also recorded. Within group data were analysed by general linear trend and intergroup comparisons were made with t-test. EF and FAC decreased at 0 min after CPB in both groups, but both recovered at 10 and 30 min after CPB in group II. Increase in EF and FAC in group II was about 12-15 % and 3-5 % from 0 min respectively. There was also significant improvement in posterior wall thickness and haematocrit (P<0.05) in group II. Patients in group II maintained better systolic blood pressure and heamoglobin after CPB. Chest tube drainage in first 48 hours was significantly less in group 1I (100 -18 verses 85 +/-20 ml, P<0.05), but ventilation and ICU stay were not different between the two groups. Combined ultrafiltration has beneficial effect an haemodynamics with improvement in EF and FAC. It improves haematocrit and decreases chest pulse drainage.
对30名接受体外循环（CPB）心脏手术的儿童进行前瞻性研究，以评估改良超滤（MUF）相对于传统超滤（CUF）的有益效果。通过经食管超声心动图测定射血分数（EF）、面积变化分数（FAC），并测量和比较两组接受CUF（第一组）和CUF加MUF（第二组）的舒张末期和收缩末期后壁厚度。还记录了血流动力学数据、血细胞比容、体温漂移、术后48小时内的胸腔引流管引流量、通气情况和重症监护病房（ICU）住院时间。组内数据采用一般线性趋势分析，组间比较采用t检验。两组在CPB后0分钟时EF和FAC均下降，但第二组在CPB后10分钟和30分钟时均恢复。第二组的EF和FAC从0分钟起分别增加约12 - 15%和3 - 5%。第二组的后壁厚度和血细胞比容也有显著改善（P<0.05）。第二组患者在CPB后维持了更好的收缩压和血红蛋白水平。第二组术后48小时内的胸腔引流管引流量明显更少（100 - 18对85 +/- 20 ml，P<0.05），但两组的通气情况和ICU住院时间无差异。联合超滤对血流动力学有有益影响，可改善EF和FAC。它能提高血细胞比容并减少胸腔引流。
