ASSESSMENT OF CONVENTIONAL ULTRAFILTRATION IN ADULT PATIENTS UNDERGOING CARDIOPULMONARY BYPASS IN CORONARY ARTERY BYPASS GRAFTING

Abstract

Cardiopulmonary bypass (CPB) is a necessary part of cardiac surgery but it also carries with it the hemodilution, inflammatory response, and modified hematological parameters. The conventional Ultrafiltration (CUF) has been a popular adjuncts method to reduce fluid overload, eliminate inflammatory mediators, and improve hematocrit levels in CPB.

Objective: To assess the use of conventional ultrafiltration in adult patients undergoing cardiopulmonary bypass in coronary artery bypass grafting

Methodology: The study was a descriptive analytical study of 81 patients that underwent cardiac surgery using CPB. Data were gathered on demographic variables, type of operation and preoperative hemoglobin, perfusion practices, intraoperative hematocrit, transfusion requirements and postoperative hemoglobin levels. Statistical software SPSS were used to analyze the data. Associations were tested via the Chi-square test to determine associations between categorical variables and binary logistic regression was used to determine independent predictors of CUF application. A p-value of <0.05 was considered statistically significant.

Results: Most of the patients were aged 1830 years (45.7%), and there was a slight female preponderance (53.1%). The most prevalent surgeries were congenital cardiac surgery (48.1%). The use of CUF was 59.3 percent in patients. Significant associations were found between CUF application and type of surgery (p < 0.001), gender (p = 0.012), preoperative hemoglobin levels (p < 0.001), and intraoperative hematocrit levels (p < 0.001). Nonetheless, there was no notable correlation with the need to receive transfusion (p = 0.229) or postoperative hemoglobin levels (p = 0.545). To determine the independent predictor of CUF application, the analysis of logistic regression identified type of surgery (p = 0.028).

Conclusion: The traditional Ultrafiltration is commonly used in cardiopulmonary bypass, especially congenital cardiac surgeries. Its use is largely determined by the surgical and intraoperative hematology concerns and not postoperative hematological outcomes. CUF can still be used as a complement in the optimization of intraoperative perfusion management.