Key result
Ultrafiltration during cardiopulmonary bypass in pediatric patients resulted in lower blood IL-6 concentrations by the end of surgery compared to adults (128.4 vs 273.1 pg/ml, p<0.02).
Why the study?
Does ultrafiltration during cardiopulmonary bypass effectively remove proinflammatory cytokines in pediatric patients less than 18 months old undergoing correction of ventricular septal defects?
Observational
Does ultrafiltration during cardiopulmonary bypass effectively remove proinflammatory cytokines in pediatric patients less than 18 months old undergoing correction of ventricular septal defects?
Absolute Event Rate: 128.4% vs 273.1%
p-value: p=<0.02
Ultrafiltration during cardiopulmonary bypass in pediatric patients is highly effective at removing proinflammatory cytokines like IL-6 and IL-8, outperforming renal filtration alone.
Lower IL-6 with ultrafiltration in pediatric versus adult patients is hypothesis-generating; prospective trials needed before clinical adoption in infant VSD repair.
The effect of ultrafiltration during cardiopulmonary bypass (CPB) was evaluated for correcting ventricular septal defects with associated pulmonary hypertension in patients less than 18 months old. Interleukin (IL)-6 and IL-8 concentrations in the blood, ultrafiltrate, and urine were measured. The blood IL-6 concentration increased to 128.4+/-20.2 pg/ml by the end of surgery, which is lower than the concentration seen in adult patients (273.1+/-48.2 pg/ml, p < 0.02). The blood IL-8 concentration was not significantly different than that of adults. The total amounts of excreted IL-6 in the ultrafiltrate and urine during CPB were 11.5+/-0.32 pg/kg and 0.32+/-0.07 pg/kg, respectively (p < 0.05). The total amounts of excreted IL-8 in the ultrafiltrate and urine were 4.64+/-0.69 pg/kg and 1.92+/-0.56 pg/kg, respectively (p < 0.05). No differences were seen in these values for excretion between children and adults. We conclude that ultrafiltration during CPB in pediatric patients is more effective in removing proinflammatory cytokines than in adults and more effective than renal filtration alone.
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Watanabe et al. (1998) conducted an observational in Ventricular septal defects with associated pulmonary hypertension. Ultrafiltration during cardiopulmonary bypass vs. Adult patients was evaluated on Blood IL-6 concentration by the end of surgery (p=<0.02). Ultrafiltration during cardiopulmonary bypass in pediatric patients resulted in lower blood IL-6 concentrations by the end of surgery compared to adults (128.4 vs 273.1 pg/ml, p<0.02).
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