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

• 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

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.