Effect of combined Conventional Ultrafiltration and Modified Ultrafiltration on Serum Interleukin-6 and TNF-α Levels in Pediatric Cardiac Surgery Patients
Journal of Cellular & Molecular Anesthesia,
Vol. 4 No. 1 (2019),
15 August 2019
,
Page 3-7
https://doi.org/10.22037/jcma.v4i1.26197
Abstract
Abstract
Background: Water retention occurs in most of the congenital heart surgery patients, especially in pediatrics. Ultrafiltration excretes water, electrolytes, many free radicals and inflammatory mediators. The aim of this study was to investigate the effect of modified ultrafiltration (MUF) on the serum levels of TNF-α and IL-6 in pediatrics patients undergoing congenital heart surgeries.Methods and Materials: A total of 91 pediatric congenital heart disease patients candidate for total correction were selected and divided randomly in two groups: CUF (Conventional Ultrafiltration) and CUF+MUF; 40 patients were allocated to CUF group and 51 patients to CUF+MUF group. Serum levels of TNF-α and IL-6 were assessed before CPB and 6 hours after the end of the operation in ICU. Postoperative levels of TNF-α and IL-6 were compared between the two groups.Results: In the MUF+CUF group, the preoperative and postoperative TNF-α levels were 2.5±5.6 and 1.4±3.0 respectively. However, IL-6 serum levels before and after operation were 4.8±8.9 and 41±56. In the CUF only group, the TNF-α level before and after surgery was 3.1±6.2 and 1.0±0.44; respectively; similarly, IL-6 serum levels were 3.3±8.2 and 34.8±37.7.Conclusion: MUF in congenital heart surgery could filtrate excess water and elevate hematocrit but does not have a definitive role in reducing TNF-α and IL-6 serum levels.Keywords: MUF, TNF-α, IL-6, CUF, cardiopulmonary bypass
- Ultrafiltration
- Interleukin-6
- TNF-alpha
- Congenital Heart Defect
- Cardiopulmonary Bypass
- Heart Surgery
How to Cite
References
Brancaccio G, Villa E, Girolami E, Michielon G, Feltri C, Mazzera E, Costa D, Isacchi G, Iannace E, Amodeo A, Di Donato RM. Inflammatory cytokines in pediatric cardiac surgery and variable effect of the hemofiltration process. Perfusion. 2005;20(5):263-8.
Wang MJ, Chiu IS, Hsu CM, Wang CM, Lin PL, Chang CI, Huang CH, Chu SH. Efficacy of ultrafiltration in removing inflammatory mediators during pediatric cardiac operations. Ann Thorac Surg. 1996;61(2):651-6.
Tamme K, Maddison L, Kruusat R, Ehrlich HE, Viirelaid M, Kern H, Starkopf J. Effects of high volume haemodiafiltration on inflammatory response profile and microcirculation in patients with septic shock. Biomed Res Int. 2015;2015:125615.
Golab HD, Kissler J, de Jong PL, van de Woestijne PC, Takkenberg JJ, Bogers AJ. Clinical outcome and blood transfusion after infant cardiac surgery with a routine use of conventional ultrafiltration. Perfusion. 2015;30(4):323-31.
Whiting D, Yuki K, DiNardo JA. Cardiopulmonary bypass in the pediatric population. Best Pract Res Clin Anaesthesiol. 2015;29(2):241-56.
Berdat PA, Eichenberger E, Ebell J, Pfammatter JP, Pavlovic M, Zobrist C, Gygax E, Nydegger U, Carrel T. Elimination of proinflammatory cytokines in pediatric cardiac surgery: analysis of ultrafiltration method and filter type. J Thorac Cardiovasc Surg. 2004;127(6):1688-96.
Torina AG, Silveira-Filho LM, Vilarinho KA, Eghtesady P, Oliveira PP, Sposito AC, Petrucci O. Use of modified ultrafiltration in adults undergoing coronary artery bypass grafting is associated with inflammatory modulation and less postoperative blood loss: a randomized and controlled study. J Thorac Cardiovasc Surg. 2012 Sep;144(3):663-70.
Fitzgerald DJ, Cecere G. Hemofiltration and inflammatory mediators. Perfusion. 2002;17 Suppl:23-8.
- Abstract Viewed: 202 times
- PDF Downloaded: 146 times