The effects of perioperative ultrafiltration on postoperative outcomes in dialysis-dependent patients undergoing open heart surgery

Background: This study aims to investigate the effects of perioperative ultrafiltration (UF) on postoperative outcome in hemodialysis-dependent patients undergoing open heart surgery. Methods: Between March 2000 and May 2008, 46 hemodialysis-dependent patients who underwent open heart surgery were included. Patients were divided into two groups based on utilization of ultrafiltration: UF (+) and UF (-) group. All patients underwent hemodialysis one day before surgery and two days after surgery. Of 46 patients, 26 had UF during surgery (UF (+) group). The length of hospital stay including intensive care unit and morbidity and mortality rates were compared between the groups. Pre- and postoperative central venous pressure, blood urea nitrogen (BUN), creatinine, serum potassium, hemoglobin (Hgb) concentrations were analyzed. Results: The length of intensive care unit stay (56±28 hours vs. 95±93 hours, respectively; p=0.04) and hospital stay (5.5±1.4 days vs. 8.1±3.4 days, respectively; p=0.002) were significantly different between the groups. There were significant differences in postoperative mean values of BUN (50.6±13.5 mg/dl vs. 59.8±13.7 mg/dl, respectively; p=0.02) and hemoglobin (9.9±1.0 g/dl vs. 8.8±0.9 g/dl, respectively; p=0.001) between the groups. Conclusion: Utility of perioperative UF in dialysisdependent patients during open heart surgery may shorten the length of hospital stay and improve biochemical and hemodynamic parameters.