Modified Low-Flow Ultrafiltration Ameliorates Hemodynamics and Early Graft Function and Reduces Blood Loss in Living-Donor Lobar Lung Transplantation
| Autor: | Shunji Sano, Mahito Nakakura, Atsushi Ito, Keiji Goto, Yasufumi Fujita, Yasuhiro Kotani, Kazutoshi Kotani, Hiroshi Date, Osami Honjo, Masaaki Kawada |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Lung Diseases Male Pulmonary and Respiratory Medicine Blood transfusion Adolescent medicine.medical_treatment Blood Loss Surgical Hemodynamics law.invention Young Adult law Living Donors Cardiopulmonary bypass Humans Medicine Adverse effect Retrospective Studies Transplantation Cardiopulmonary Bypass Lung business.industry Graft Survival Middle Aged Blood pressure medicine.anatomical_structure Anesthesia Circulatory system Female Surgery Hemofiltration Cardiology and Cardiovascular Medicine business Lung Transplantation |
| Zdroj: | The Journal of Heart and Lung Transplantation. 28:340-346 |
| ISSN: | 1053-2498 |
| Popis: | This study analyzed the clinical application of modified low-flow ultrafiltration (MUF) to minimize cardiopulmonary bypass (CPB)-related adverse effects in patients undergoing living-donor lobar lung transplantation (LDLLT).The study enrolled 33 consecutive patients who underwent LDLLT from 1999 to 2004: 8 patients underwent conventional CPB without MUF (control group), and 15 underwent arteriovenous MUF (MUF-treated group). Hemodynamics, graft function, blood loss and blood transfusion requirements, and clinical outcomes were analyzed.There was a significant increase in systolic blood pressure and a decrease in pulmonary to systemic pressure ratio in the MUF-treated group (p0.05). No hemodynamic changes occurred in the control group. MUF resulted in significant improvements in arterial oxygen tension/fraction of inspired oxygen ratio (PaO(2)/FiO(2;) 411 +/- 107 vs 272 +/- 107 mm Hg, p0.05) and the alveolar-arterial oxygen difference (a-aDO(2); 158 +/- 84 vs 315 +/- 127 mm Hg, p0.05) at 15 minutes after CPB. There were no differences in PaO(2)/FiO(2) and A-aDO(2) between the groups beyond 6 hours post-operatively. Post-operative blood loss and blood transfusion requirements were lower in the MUF-treated group than in the control group (p0.05). There were no differences in survival, duration of ventilation, intensive care unit stay, and hospital stay between the groups.The low-flow MUF brought improved hemodynamics and gas exchange capacity of transplanted grafts and lowered post-operative blood loss and blood transfusion requirement. This strategy may minimize CPB-related adverse effects in patients undergoing LDLLT. |
| Databáze: | OpenAIRE |
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