The effect of modified ultrafiltration duration on pulmonary functions and hemodynamics in newborns and infants following arterial switch operation

Ayda Türköz, Ezgi Tunçay, Şule Turgut Balci, Meltem Güner Can, Dilek Altun, Riza Türköz, Akif Ündar

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: Modified ultrafiltration is used to ameliorate the deleterious effects of cardiopulmonary bypass in pediatric cardiac surgery patients. The ideal duration of modified ultrafiltration has not been established yet. We investigated the effects of extended duration of modified ultrafiltration on pulmonary functions and hemodynamics in the early postoperative period in newborns and infants who had transposition of great arteries operations. Design: Single-center prospective randomized study. Setting: Pediatric cardiac surgery operating room and ICU. Patients: Sixty newborns and infants who had been scheduled to undergo transposition of great arteries operation. Interventions: None. Measurements and Main Results: Modified ultrafiltration was applied to all patients following the termination of cardiopulmonary bypass (for 10, 15, and 20min in groups 1, 2, and 3, respectively). Pulmonary compliance, gas exchange capacity, hemodynamic measurements, inotropic support, blood loss, transfusion requirements, hematocrit level, and duration of ventilatory support were measured after intubation, at termination of cardiopulmonary bypass, at the end of modified ultrafiltration, and in the 1st, 6th, 12th, and 24th hours after admission to ICU. The amount of fluid removed by modified ultrafiltration in groups 2 and 3 was larger than that of group 1 (p < 0.01). Systolic blood pressure was significantly increased at the end of modified ultrafiltration in group 3 compared to groups 1 and 2 (p < 0.05). Hematocrit levels were significantly increased at the end of modified ultrafiltration in groups 2 and 3 compared to group 1 (p<0.01). Therefore, RBCs were transfused less after modified ultrafiltration in groups 2 and 3 compared to group 1 (p < 0.05). Static and dynamic compliance, oxygen index, and ventilation index had improved similarly in all three groups at the end of modified ultrafiltration (p > 0.05) Conclusions: Modified ultrafiltration acutely improved pulmonary compliance and gas exchange in all groups. Increased hematocrit and blood pressure levels were also observed in the longer modified ultrafiltration group. However, extended duration of modified ultrafiltration did not have a significant impact on duration of intubation or the stay in ICU.

Original languageEnglish (US)
Pages (from-to)600-607
Number of pages8
JournalPediatric Critical Care Medicine
Volume15
Issue number7
DOIs
StatePublished - Jan 1 2014

Fingerprint

Ultrafiltration
Hemodynamics
Newborn Infant
Lung
Cardiopulmonary Bypass
Pulmonary Gas Exchange
Lung Compliance
Transposition of Great Vessels
Hematocrit
Intubation
Thoracic Surgery
Pediatrics
Arterial Switch Operation
Operating Rooms
Postoperative Period
Blood Transfusion
Prospective Studies
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Türköz, Ayda ; Tunçay, Ezgi ; Balci, Şule Turgut ; Can, Meltem Güner ; Altun, Dilek ; Türköz, Riza ; Ündar, Akif. / The effect of modified ultrafiltration duration on pulmonary functions and hemodynamics in newborns and infants following arterial switch operation. In: Pediatric Critical Care Medicine. 2014 ; Vol. 15, No. 7. pp. 600-607.
@article{1c9e4f7c712148af805a0ac488ce1cc6,
title = "The effect of modified ultrafiltration duration on pulmonary functions and hemodynamics in newborns and infants following arterial switch operation",
abstract = "Objectives: Modified ultrafiltration is used to ameliorate the deleterious effects of cardiopulmonary bypass in pediatric cardiac surgery patients. The ideal duration of modified ultrafiltration has not been established yet. We investigated the effects of extended duration of modified ultrafiltration on pulmonary functions and hemodynamics in the early postoperative period in newborns and infants who had transposition of great arteries operations. Design: Single-center prospective randomized study. Setting: Pediatric cardiac surgery operating room and ICU. Patients: Sixty newborns and infants who had been scheduled to undergo transposition of great arteries operation. Interventions: None. Measurements and Main Results: Modified ultrafiltration was applied to all patients following the termination of cardiopulmonary bypass (for 10, 15, and 20min in groups 1, 2, and 3, respectively). Pulmonary compliance, gas exchange capacity, hemodynamic measurements, inotropic support, blood loss, transfusion requirements, hematocrit level, and duration of ventilatory support were measured after intubation, at termination of cardiopulmonary bypass, at the end of modified ultrafiltration, and in the 1st, 6th, 12th, and 24th hours after admission to ICU. The amount of fluid removed by modified ultrafiltration in groups 2 and 3 was larger than that of group 1 (p < 0.01). Systolic blood pressure was significantly increased at the end of modified ultrafiltration in group 3 compared to groups 1 and 2 (p < 0.05). Hematocrit levels were significantly increased at the end of modified ultrafiltration in groups 2 and 3 compared to group 1 (p<0.01). Therefore, RBCs were transfused less after modified ultrafiltration in groups 2 and 3 compared to group 1 (p < 0.05). Static and dynamic compliance, oxygen index, and ventilation index had improved similarly in all three groups at the end of modified ultrafiltration (p > 0.05) Conclusions: Modified ultrafiltration acutely improved pulmonary compliance and gas exchange in all groups. Increased hematocrit and blood pressure levels were also observed in the longer modified ultrafiltration group. However, extended duration of modified ultrafiltration did not have a significant impact on duration of intubation or the stay in ICU.",
author = "Ayda T{\"u}rk{\"o}z and Ezgi Tun{\cc}ay and Balci, {Şule Turgut} and Can, {Meltem G{\"u}ner} and Dilek Altun and Riza T{\"u}rk{\"o}z and Akif {\"U}ndar",
year = "2014",
month = "1",
day = "1",
doi = "10.1097/PCC.0000000000000178",
language = "English (US)",
volume = "15",
pages = "600--607",
journal = "Pediatric Critical Care Medicine",
issn = "1529-7535",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

The effect of modified ultrafiltration duration on pulmonary functions and hemodynamics in newborns and infants following arterial switch operation. / Türköz, Ayda; Tunçay, Ezgi; Balci, Şule Turgut; Can, Meltem Güner; Altun, Dilek; Türköz, Riza; Ündar, Akif.

In: Pediatric Critical Care Medicine, Vol. 15, No. 7, 01.01.2014, p. 600-607.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The effect of modified ultrafiltration duration on pulmonary functions and hemodynamics in newborns and infants following arterial switch operation

AU - Türköz, Ayda

AU - Tunçay, Ezgi

AU - Balci, Şule Turgut

AU - Can, Meltem Güner

AU - Altun, Dilek

AU - Türköz, Riza

AU - Ündar, Akif

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objectives: Modified ultrafiltration is used to ameliorate the deleterious effects of cardiopulmonary bypass in pediatric cardiac surgery patients. The ideal duration of modified ultrafiltration has not been established yet. We investigated the effects of extended duration of modified ultrafiltration on pulmonary functions and hemodynamics in the early postoperative period in newborns and infants who had transposition of great arteries operations. Design: Single-center prospective randomized study. Setting: Pediatric cardiac surgery operating room and ICU. Patients: Sixty newborns and infants who had been scheduled to undergo transposition of great arteries operation. Interventions: None. Measurements and Main Results: Modified ultrafiltration was applied to all patients following the termination of cardiopulmonary bypass (for 10, 15, and 20min in groups 1, 2, and 3, respectively). Pulmonary compliance, gas exchange capacity, hemodynamic measurements, inotropic support, blood loss, transfusion requirements, hematocrit level, and duration of ventilatory support were measured after intubation, at termination of cardiopulmonary bypass, at the end of modified ultrafiltration, and in the 1st, 6th, 12th, and 24th hours after admission to ICU. The amount of fluid removed by modified ultrafiltration in groups 2 and 3 was larger than that of group 1 (p < 0.01). Systolic blood pressure was significantly increased at the end of modified ultrafiltration in group 3 compared to groups 1 and 2 (p < 0.05). Hematocrit levels were significantly increased at the end of modified ultrafiltration in groups 2 and 3 compared to group 1 (p<0.01). Therefore, RBCs were transfused less after modified ultrafiltration in groups 2 and 3 compared to group 1 (p < 0.05). Static and dynamic compliance, oxygen index, and ventilation index had improved similarly in all three groups at the end of modified ultrafiltration (p > 0.05) Conclusions: Modified ultrafiltration acutely improved pulmonary compliance and gas exchange in all groups. Increased hematocrit and blood pressure levels were also observed in the longer modified ultrafiltration group. However, extended duration of modified ultrafiltration did not have a significant impact on duration of intubation or the stay in ICU.

AB - Objectives: Modified ultrafiltration is used to ameliorate the deleterious effects of cardiopulmonary bypass in pediatric cardiac surgery patients. The ideal duration of modified ultrafiltration has not been established yet. We investigated the effects of extended duration of modified ultrafiltration on pulmonary functions and hemodynamics in the early postoperative period in newborns and infants who had transposition of great arteries operations. Design: Single-center prospective randomized study. Setting: Pediatric cardiac surgery operating room and ICU. Patients: Sixty newborns and infants who had been scheduled to undergo transposition of great arteries operation. Interventions: None. Measurements and Main Results: Modified ultrafiltration was applied to all patients following the termination of cardiopulmonary bypass (for 10, 15, and 20min in groups 1, 2, and 3, respectively). Pulmonary compliance, gas exchange capacity, hemodynamic measurements, inotropic support, blood loss, transfusion requirements, hematocrit level, and duration of ventilatory support were measured after intubation, at termination of cardiopulmonary bypass, at the end of modified ultrafiltration, and in the 1st, 6th, 12th, and 24th hours after admission to ICU. The amount of fluid removed by modified ultrafiltration in groups 2 and 3 was larger than that of group 1 (p < 0.01). Systolic blood pressure was significantly increased at the end of modified ultrafiltration in group 3 compared to groups 1 and 2 (p < 0.05). Hematocrit levels were significantly increased at the end of modified ultrafiltration in groups 2 and 3 compared to group 1 (p<0.01). Therefore, RBCs were transfused less after modified ultrafiltration in groups 2 and 3 compared to group 1 (p < 0.05). Static and dynamic compliance, oxygen index, and ventilation index had improved similarly in all three groups at the end of modified ultrafiltration (p > 0.05) Conclusions: Modified ultrafiltration acutely improved pulmonary compliance and gas exchange in all groups. Increased hematocrit and blood pressure levels were also observed in the longer modified ultrafiltration group. However, extended duration of modified ultrafiltration did not have a significant impact on duration of intubation or the stay in ICU.

UR - http://www.scopus.com/inward/record.url?scp=84926116830&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84926116830&partnerID=8YFLogxK

U2 - 10.1097/PCC.0000000000000178

DO - 10.1097/PCC.0000000000000178

M3 - Article

C2 - 24977688

AN - SCOPUS:84926116830

VL - 15

SP - 600

EP - 607

JO - Pediatric Critical Care Medicine

JF - Pediatric Critical Care Medicine

SN - 1529-7535

IS - 7

ER -