Ultrafiltração convencional com modificação técnica no tratamento cirúrgico dos defeitos cardíacos congênitos

Objective: To compare patients submitted to conventional ultrafiltration (CUF) with and without a technical modification that allows the use of residual blood from the circuit tubes and oxygenator. Method: From March 2002 to January 2005, 301 patients undergoing congenital heart defect surgery with cardiopulmonary bypass (CPB) were retrospectively analyzed and divided into two groups: Group A - 130 submitted to CUF and Group B, 171 patients submitted to CUF with a technical modification that uses residual blood. Demographic data, diagnosis, surgical treatment, intra-operative and postoperative data, the need and amount of blood transfusions, laboratorial results and length of hospital stay were compared between the groups. Results: There was no differences in the initial hematocrit before CPB (p = 0.06), but in Group B, the values after ultrafiltration were higher (p <0.0001). Group B patients received more transfusions in the first 48 hours of the postoperative period (p <0.0001). There was no significant difference in the time of mechanical ventilation (p = 0.34), but the inotropic support (p <0.0001), antibiotic therapy (p = 0.0006), length of stay in the intensive care unit (p <0.0001) and length of hospital stay (p <0.0001) were greater for Group B. Conclusions: CUF with the technical modification was not better than conventional CUF, because in spite of elevating the hematocrit after CBP, it caused greater postoperative bleeding with a greater need of blood transfusions and longer hospital stays.

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