MODIFIED ULTRAFILTRATION IN ADULT CARDIAC SURGERY IS IT REALLY BENEFICIAL?

Background: Cardiopulmonary bypass initiates systemic inflammatoryresponse syndrome (SIRS) causing deleterious effects on various body systems with increased morbidity. Modifiedultrafiltration (MUF) is a technique that removes excess water and inflammatory mediators from the circulation in thepost-bypass period resulting in reduced bleeding, less blood transfusion requirements and overall reduced morbidity.Materials and Methods: 96 patients were randomly selected and divided into two groups. In Group I called MUF group(n=50), modified ultrafiltration was carried out for 15 min in the post bypass period. Group II called NON-MUFgroup(n=46), MUF was not carried out. Clinical assessment was based on ASA class. Mean cardiopulmonary bypass andaortic cross clamp times were 95.42 &56.94 min and 77.98 & 43.64 min in the MUF & NON-MUF groups respectively.Variables were expressed as mean and percentage. In the MUF group , there was increase in Hb by more than 2g/dlin 32 patients (64%) whereas in the NON-MUF group, this increase was only in 12 patients (20%). Mean postoperativechest drainage was far less (422 ml) in MUF group as compared to NON-MUF group (842.50 ml).Transfusion(449.12ml Vs 996.58 ml) and postoperative ventilatory requirements(40% Vs 47.8%) were also less in MUF group thanNON-MUF group. Inotropic support was nearly comparable in both the groups but overall morbidity (Low cardiac outputstate, sepsis, reopening) was less in the MUF group (18%) as compared to NON-MUF group (30%). Mean ICU staywas also less in MUF group (mean 51.52 hrs) than in NON-MUF group (mean 55.43 hrs). One patient in each groupdied. Conclusion: Modified Ultrafiltration is associated with improved hemoglobin, less postoperative bleeding,reopening and transfusion requirements with overall reduced morbidity and ICU stay. However, the need for inotropeswere not significantly different in the two groups.