Key result
Modified ultrafiltration reduces ventilator support time by ~7 hours vs conventional ultrafiltration in valve replacement.
Why the study?
Modified ultrafiltration may improve outcomes after extracorporeal circulation in valve replacement surgery, but its effects on inflammatory markers and cardiopulmonary function require investigation.
Does modified ultrafiltration improve postoperative cardiopulmonary recovery and reduce inflammation in patients with valvular disease undergoing valve replacement surgery?
RCT (n=62)
Random number table
No
Does modified ultrafiltration improve postoperative cardiopulmonary recovery and reduce inflammation in patients with valvular disease undergoing valve replacement surgery?
Absolute Event Rate: 17.15% vs 24.06%
p-value: p=<0.05
Modified ultrafiltration during cardiopulmonary bypass for valve replacement surgery attenuates early postoperative systemic inflammation and improves cardiopulmonary function compared to conventional ultrafiltration.
Supports modified ultrafiltration in valve replacement; extends RCT evidence favoring its use over conventional ultrafiltration during cardiopulmonary bypass.
Background: To investigate the effects of modified ultrafiltration in extracorporeal circulation valve replacement surgery. Methods: A total of 62 patients with valvular disease who underwent valve replacement were included. They were randomly divided into the conventional ultrafiltration group (CUF group, n=31) and the modified ultrafiltration group (MUF group, n=31). The hematocrit (Hct) values, volume of pleural fluid drainage at 24 hours after operation, Intensive Care Unit (ICU) stay time, postoperative 24-hour blood loss, bank blood usage, postoperative 24-hour urine volume, ventilator support time, cardiac function indexes, postoperative changes of respiratory function, and levels of inflammatory factors in both groups were compared. Results: After ultrafiltration, the MUF group showed higher Hct value and reduced volume of pleural fluid drainage, blood loss, bank blood usage, urine volume and ventilator support time 24 hours after operation compared with the CUF group (P<0.05). After surgery, left ventricular ejection fraction (LVEF) levels were elevated, and those in the MUF group were higher than those in the CUF group. Left ventricular end-diastolic diameter (LVEDD) and heart rate (HR) were decreased in both groups after surgery. They were lower in the MUF group than in the CUF group (P<0.05). After ultrafiltration, the OI value in the MUF group was higher, and the alveolar-arterial oxygen partial pressure gradient (P (A-a)O2) value was lower than the CUF group (P<0.05). The plasma concentrations of interleukin 6 (IL-6) and tumour necrosis factor-alpha (TNF-a) were increased after cardiopulmonary bypass (CPB) in both groups and then decreased after ultrafiltration, and IL-6 and TNF-a levels in MUF group were lower than those in CUF group (P<0.05). Conclusions: MUF attenuates the postoperative systemic inflammatory response, reduces the lung injury caused by CPB, and improves the lung function of patients in the early postoperative period, which benefits patient recovery after surgery and is valuable in heart valve replacement.
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Geng et al. (2025) conducted an RCT in Valvular heart disease (n=62). Modified ultrafiltration vs. Conventional ultrafiltration was evaluated on Ventilator support time (hours) (p=<0.05). Modified ultrafiltration significantly reduced ventilator support time (17.15 vs 24.06 hours) and bank blood usage (379.64 vs 586.73 mL) compared to conventional ultrafiltration in patients undergoing extracorporeal circulation in valve replacement.
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