Ultrafiltration in Pediatric Cardiac Surgery: An Observational Cohort Study

IWK Health Centre40 enrolled

Overview

Infants and children undergoing cardiac surgery with cardiopulmonary bypass (CPB) can experience systemic inflammation that prolongs post-operative recovery. Ultrafiltration is an intra-opreative technique that is hypothesized to extract circulating inflammatory mediators during the CPB time. There have been only a few small studies looking at a limited number of inflammatory marker profiles in this context. Our institution uses an innovative form of ultrafiltration "subzero-balance simple-modified ultrafiltration" (SBUF-SMUF) throughout the entire CPB time. SBUF-SMUF has been our standard of care for the last 5 years. This observational seeks to describe the clinical and immunologic outcomes of infants and children undergoing cardiac surgery with CBP and SBUF-SMUF.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Congenital Heart Disease Inflammation

Interventions

SBUF-SMUFPROCEDURE

Intra-operative continuous ultrafiltration

Eligibility

Sex: ALLMax age: 15 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Congenital cardiac patients (\< 30kg) that have been consented to a planned cardiac surgery procedure requiring cardiopulmonary bypass at the IWK Health Centre. * Patient or family consent to participate in the study. Exclusion Criteria: * Patient or family refusal to participate. * Known genetic syndrome with multi-organ abnormalities and immune dysfunction such as DiGeorge Syndrome, Trisomy 18 or 13, Noonan syndrome. * Known immunodeficiency syndrome or bone marrow pathology. * Severe liver disease with abnormal synthetic liver function tests.

Outcomes

Primary Outcomes

Inflammatory Mediator C3a

C3a

Time frame: Sampled at the end of CPB

Inflammatory Mediator C5a

Time frame: Measured at the end of CPB

Inflammatory Mediator IL-6

Time frame: Measured at the end of CPB

Inflammatory Mediator IL-8

Time frame: Measured at the end of CPB

Secondary Outcomes

Vasoactive-Ventilation-Renal Score

Scale 0-60. Higher value resembles medical instability and a worse prognosis.

Time frame: Upon ICU Admission

Vasoactive-Inotrope Score

Scale 0-40. Higher value resembles medical instability and a worse prognosis.

Time frame: Upon ICU admission

Ventilation Index

Scale 0-40. Higher value resembles medical instability and a worse prognosis.

Time frame: Upon ICU Admission

Oxygenation Index

Scale 0-20. Higher value resembles medical instability and a worse prognosis.

Time frame: Upon ICU admission

Ventilation Time

Time on mechanical ventillator.

Time frame: Upon ICU Admission

Intensive Care Unit Length of Stay

Standardized Discharge Criteria

Time frame: Through study completion, an average of 1 week.

Acute Kidney Injury

Kidney Disease Improving Global Outcomes criteria with Stages 1-3

Time frame: Through study completion, an average of 1 week.

Ultrafiltration in Pediatric Cardiac Surgery: An Observational Cohort Study

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes