Effects of Modified Ultrafiltration in Children Undergoing Repair of Complete Atrioventricular Canal Defect

Background: Cardiopulmonary bypass (CPB) results in whole body inflammatory response syndrome and increased total body water. Consequently there is an increased risk of bleeding and organ dysfunction following procedures where CPB has been used. Modified ultrafiltration (MUF) is shown to reverse some of the deleterious effects of CPB. Methods: This is a retrospective study of children undergoing repair of complete atrioventricular canal defect (CAVCD). Two groups of children were studied; in the MUF group modified ultrafiltration was used to remove body water post-CPB, in the Non-MUF group no ultrafiltration was used. Results: There were twenty patients in each group. The two groups were similar regarding age, sex, weight, preoperative blood parameters, and intraoperative and postoperative management. Children in the MUF group had significantly less postoperative blood loss, and required less red cell and plasma transfusions. The MUF group had significantly lower dopamine requirements; however there was no difference with regard to adrenaline requirements. Lastly the MUF group had significantly shorter ventilation period and ICU stay. Conclusions: Modified ultrafiltration in children undergoing repair of CAVCD results in lower blood loss and blood products requirements. In addition these children are extubated earlier and have shorter intensive care stay.