PMID: 9436573Jan 22, 1998Paper

Modified ultrafiltration attenuates dilutional coagulopathy in pediatric open heart operations

The Annals of Thoracic Surgery
R H FriesenM A Tornabene

Abstract

Extreme hemodilution caused by relatively large prime volumes required for cardiopulmonary bypass in infants causes a dilutional coagulopathy, characterized by low concentrations of fibrinogen and other circulating coagulation factors. Modified ultrafiltration results in hemoconcentration and is associated with decreases in postoperative bleeding and transfusion requirements in children. This study was undertaken to quantify the effect of modified ultrafiltration on concentrations of fibrinogen, plasma proteins, and platelets in infants and small children. Twenty patients less than 15 kg were studied. Cardiopulmonary bypass circuits were primed with crystalloid solutions. Red blood cells were added during cardiopulmonary bypass for hematocrits less than 15%. Colloid solutions were not administered. Concentrations of fibrinogen, plasma proteins, and platelets, and hematocrit were measured before cardiopulmonary bypass, before modified ultrafiltration, and after modified ultrafiltration. Modified ultrafiltration was associated with significant (p < 0.001) increases in hematocrit (19% +/- 6% to 31% +/- 9%), fibrinogen (65 +/- 29 to 101 +/- 45 mg/dL), and total plasma proteins (2.7 +/- 0.3 to 4.9 +/- 0.7 g/dL), but no change (p = 0...Continue Reading

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Citations

Jun 13, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jean-François HardyUNKNOWN Members of the Groupe d'Intérêt en Hémostase Périopératoire
Mar 10, 2001·The Annals of Thoracic Surgery·U KiziltepeH Akalin
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