37. Conventional hemofiltration during cardiopulmonary bypass increases the serum lactate level in adult cardiac surgery

To evaluate the effect of hemofiltration on lactate level in adult patients undergoing cardiac surgery. Hemofiltration increases the lactate level. The study included 283 patients classified into two groups: Hemofiltration group (n = 138), hemofiltration was done during CPB. Control group (n = 145),...

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Bibliographic Details
Main Author: R. Soliman
Format: Article
Language:English
Published: Saudi Heart Association 2016-07-01
Series:Journal of the Saudi Heart Association
Online Access:http://www.sciencedirect.com/science/article/pii/S1016731516300598
Description
Summary:To evaluate the effect of hemofiltration on lactate level in adult patients undergoing cardiac surgery. Hemofiltration increases the lactate level. The study included 283 patients classified into two groups: Hemofiltration group (n = 138), hemofiltration was done during CPB. Control group (n = 145), patients without hemofiltration. The lactate elevated in group H than group C (P < 0.05), and the PH showed metabolic acidosis in group H (P < 0.05). The mixed venous oxygen saturation decreased in group H than group C (P < 0.05). The number of transfused packed red blood cells was lower in group H than group C (P < 0.05). The hematocrit was higher in group H than group C (P < 0.05). The urine output was lower in group H than group C (P < 0.05). Hemofiltration leads to hemoconcentration, elevated lactate level and increased inotropic support. There are some recommendations for hemofiltration: First; Hemofiltration should be limited for patients with impaired renal function, positive fluid balance, reduced response to diuretics or prolonged bypass time more than 2 hours. Second; Minimal amount of fluids should be administered to maintain adequate cardiac output and reduction of priming volumes is preferable to maintain controlled hemodilution.Third; it should be done before weaning of or after cardiopulmonary bypass and not during the whole time of cardiopulmonary bypass.
ISSN:1016-7315