Modified ultrafiltration in paediatric cardiopulmonary bypass

Cardiopulmonary bypass (CPB), a nonphysiological procedure, is associated with haemodilution and the inflammatory response, causing the accumulation of body water and organ dysfunction. The purpose of this study was to evaluate the efficacy of modified ultrafiltration. Forty paediatric patients undergoing cardiac operations were randomized into a control group and a modified ultrafiltration group. Blood cells, protein and cytokine concentrations were recorded for 24 h postoperatively. As the fluid was removed at 50 ml/min, both blood cells and protein were concentrated by modified ultrafiltration (p < 0.001). The tumour necrosis factor (TNF)-alpha concentration was increased and interleukin-8 (IL-8) and endothelin (ET) concentrations were unaltered after ultrafiltration. After correction for albumin, TNF-alpha concentration changed little, and IL-8 and ET concentrations (36.75 +/- 12.35, 42.89 +/- 15.54) were decreased significantly (21.47 +/- 13.87, 26.06 +/- 12.54) after ultrafiltration. Modified ultrafiltration is an effective method for removing excess tissue fluid and concentrating blood after CPB. This technique can also filter out some cytokines.