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Advanced Stem Cell 2018 Journal of Stem Cell Biology and Transplantation
ISSN: 2575-7725 Page 32
December 03-04, 2018
Valencia, Spain
15th Edition of EuroSciCon Conference on
Advanced Stem Cell &
Regenerative Medicine
Background: Ultrafiltration, which is currently considered as
a standard method to remove excess water administered
during cardiopulmonary bypass (CPB), aims to minimize the
adverse effects of hemodilution, such as tissue edema and
blood transfusion. Three ultrafiltration techniques can be used
before, during and after CPB procedure, including conventional
ultrafiltration (CUF), zero-balance ultrafiltration (Z-BUF), and
modified ultrafiltration (MUF) at the end of CPB. The aim of
study The present abstract attempts to revise efficiency of Z-BUF
ultrafiltration method, laboratory results, and clinical impacts.
Material and methods: 92 adults (51 men and 41 women) with
acquired heart diseases were undergoing a single cardiac
surgical procedure in condition of cardiopulmonary bypass
(clamp aortic 89, 9± 38,8min. and pump 135,14 ± 45,17min. were
divided into 3 groups. 1st group (no ultrafiltration) - 35 patients
with classic cardiac surgery, 2nd with use of zero-balance
ultrafiltration (ZBUF) group- 39 patients with classic cardiac
surgery, and 3rd group ZBUF with miniinvasive cardiac surgery-
18 patients. ZBUF was performed by removing in ratio 3 l/m2
ultrafiltrate using a hemoconcentrator with priming volume 133
ml. For myocardial protection was used “Bretschneider” solution
or blood cardioplegia with solution St. Thomas II (15 mL/kg) were
performed. Patient data was taken before CPB (T1), immediately
following CPB (T2), and 12 hours following the procedure (T3).
There were no significant differences in diagnoses, clinical status,
pump time, aortic cross-clamp time between groups.
Results: Laboratory data demonstrate presence of SIRS in all
groups (high levels of leucocytes or monocytes, C reactive
protein positive in 10,5% cases of 1st gr,11,2% cases of 2nd gr.
and 10,9%in 3rd gr.). The length of mechanical ventilation was
statistically lower more in 3rd ZBUF group and in 2nd ZBUF
group than in 1st group (1,4 ±0,3 hour (3rd gr.), 2,5±1,7 hour
(2nd ) and 3,8±1,8 hour(3rd ),P 0,01). The length of stay in ICU
was statistically lower in 2nd ZBUF group (2,2± 1,5 days) versus
(3,5±1,3 days) control group P = 0,03
Conclusions: This study demonstrates that ZBUF ultrafiltration is
an efficient method that can be used during CPB in the adults and
help to remove significant amounts of body water what seriously
impact clinical results. The use of ultrafiltration in our study had
no effect on organ dysfunction during the postoperative period
and should be used for volemic control in patients who undergo
extracorporeal circulation. This result suggests that Z-BUF
improves the pulmonary function in this model of severe lung
injury and may be an effective tool in attenuating the CPB derived
inflammatory process.
Biography
Eugen Varlan was advised as stager reseacher in scientific laboratory of
cardiosurgery of Cardiology Institute In 1995 and in few months (november
1995) sucessfully performed extracorporeal circulation in cardiac surgery
operations. During 23 years she performed above 3600 extracorporal cir-
culations in majority cases of pediatric cardiac surgery (radical correction
of Tetralogy Fallot, radical correction of Atrioventricular Canal, mitral and
tricuspidal annuloplastic, Glenn and Fontan operations with extracorporeal
circulation assistance, switch correction of Transposition of Grand vessels,
Mustard operation, Norwood corection) and off course assistance at all
types of adult operations and ECMO. By my insistence was introduced in
practice in Republic of Moldova the method of modified ultrafiltration (can
see my publications in” Art of surgery”- journal of Moldavian surgery soci-
ety). Currently working at “SANADOR” hospital in Bucharest the capital of
Romania Republic.
Is Zero-Balance Ultrafiltration an effective
clinical method for SIRS prevention during
extracorporeal circulation in adults heart
diseases correction?
Eugen Varlan
Sanador hospital, Romania
Eugen Varlan, J Stem Cell Biol Transplant 2018, Volume 2
DOI: 10.21767/2575-7725-C1-002