High-Exchange Ultrafiltration to Enhance Recovery After Pediatric Cardiac Surgery: The ULTRA Randomized Controlled Trial.

What was studied

This trial looked at children having heart surgery with bypass. This kind of surgery is linked to body-wide inflammation. All 104 children weighed under 15 kg. Each child had their blood filtered during bypass, at a high or low rate. The high rate took out 60 mL/kg per hour. The low rate took out 6 mL/kg per hour. Chance decided which rate each child got. It was a double-blind trial at one center. The main test was a score of drug, breathing and kidney support after surgery.

What they found

Each group had 52 children. The main score was much the same in both groups. No child died from the surgery. Kidney injury and poor heart output did not differ between groups. Time on a breathing machine did not differ either. Time in intensive care and in hospital was also alike. The high rate group had bigger rises in some blood markers. P-selectin and interleukin-1α were among them. Another 36 markers did not differ between groups.

What it means for patients

The authors say the high rate did not lower the main score. Other health results were no different between groups. The immune markers were mostly alike in both groups. So in this trial, the high rate showed no clear gain over the low rate.

Why it is not certain yet

The trial took place at a single center. Results may not be the same at other hospitals. It only took in children under 15 kg. Both groups got some filtering, so no group went without it. The abstract does not say how long the children were followed.

Source

High-Exchange Ultrafiltration to Enhance Recovery After Pediatric Cardiac Surgery: The ULTRA Randomized Controlled Trial.

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