Comparing Ultrafiltration and Centrifugation During and After Pediatric Cardiopulmonary Bypass

Blood processing techniques related to pediatric cases have previously been generalized from adult experiences. Twenty-two pediatric patients (<25 kilograms) undergoing cardiopulmonary bypass (CPB) for various congenital defects were prospectively randomized into an ultrafiltration or centrifugation group. Sixty-one variables were compared. The blood infused from the ultrafiltration technique contained significantly more heparin (p=0.0001) and more plasma-free hemoglobin (PFH) (p=0.0001) levels than the centrifugation blood. Centrifugation patients had a significantly higher hematocrit (p=0.0066) than the ultrafiltration group twenty minutes postoperatively. The ultrafiltration patients (mean=431.82cc±116.8) received less total packed red blood cell volume before and during bypass than the centrifugation group (mean=534.091cc±113.07). In the centrifugation group, wash volumes showed positive correlation to postoperative blood sodium levels (r= +0.4006, p 0.05). PFH levels for both groups showed a significant positive correlation to postoperative creatinine levels (r= +.4029, p< 0.05) suggesting decreased postoperative renal function, but a significant negative correlation to post-bypass hematocrit (r= -.4548, p< 0.05). Post-bypass heparin levels in the circuit showed a significant positive correlation to heparin levels in the reinfusion blood for the ultrafiltration group (r= +.8025, p<0.05). Post-bypass PFH level in the circuit showed a significant positive correlation to PFH levels in the reinfusion blood for both groups (r= +.5339, p