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Korean Journal of Anesthesiology 2004;47(6):808-815.
DOI: https://doi.org/10.4097/kjae.2004.47.6.808   
Hemodynamic Effects of Modified Ultrafiltration (MUF) in Adult Patients Undergoing Valvular Heart Surgery.
Jong Hwa Lee, Wook Park, Sun Jun Bai, Ji Young Kim, Yong Kyung Lee, Jong Wook Song, Young Lan Kwak
1Department of Anesthesiology and Pain Medicine, College of Medicine, Yonsei University, Seoul, Korea. ylkwak@yumc.yonsei.ac.kr
2Anesthesia and Pain Medicine Research Institute, College of Medicine, Yonsei University, Seoul, Korea.
3Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea
Abstract
BACKGROUND
Modified ultrafiltration (MUF) has been demonstrated to have beneficial effects in children undergoing cardiac surgery with cardiopulmonary bypass (CPB). In adults, the hemodynamic effects of MUF are little known. The purpose of this investigation is to evaluate the hemodynamic effects of MUF in adult patients undergoing valvular heart surgery.
METHODS
30 patients scheduled for elective mitral valvular surgery were randomized into either Ultrafiltration (U) or Control (C) group. In the U group, MUF was performed just after termination of CPB for 20 minutes, and not in the C group. Measurements of hemodynamic variables including right ventricular ejection fraction (RVEF) measured by thermodilution technique and hematocrit were performed before induction, just after termination of CPB, after completion of MUF and after sternal closure. Measurement after MUF in the C group was performed at 20 minutes after the termination of CPB. After transfer to ICU, same measurements were performed at postoperative 6 and 12 hrs.
RESULTS
After MUF, RVEF (P < 0.05) and hematocrit (P < 0.01) increased in the U group, compared to the corresponding values measured just after termination of CPB. However, the variables were not statistically different between the two groups throughout the intraoperative procedures and during ICU stay.
CONCLUSIONS
Conclusively, MUF was demonstrated to have the transient beneficial effect of improving the right heart function and hemoconcentration immediately after termination of CPB.
Key Words: modified ultrafiltration; cardiopulmonary bypass; hemodynamics; valvular heart disease


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