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1 Department of Anaesthesiology and Intensive Care, University Hospital Erlangen, Germany

E. Effects of modified ultrafiltration on extravascular lung water and intrathoracic blood volume. Palmaers T 1 , Bremer F. 1 , Eberle K 1 , Ehe T 1 , Muench F 2 , Hakami L 2 , Weyand M 2 , Cesnjevar R 2. 1 Department of Anaesthesiology and Intensive Care, University Hospital Erlangen, Germany

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1 Department of Anaesthesiology and Intensive Care, University Hospital Erlangen, Germany

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  1. E Effects of modified ultrafiltration on extravascular lung water and intrathoracic blood volume Palmaers T1, Bremer F.1, Eberle K1, Ehe T1, Muench F2, Hakami L2, Weyand M2, Cesnjevar R2 1Department of Anaesthesiology and Intensive Care, University Hospital Erlangen, Germany 2Department of Cardiac Surgery, University Hospital Erlangen, Germany Background and Goal of Study: Modified ultrafiltration (MUF) [1] improves haemodynamics and reduces total body water significantly after cardiopulmonary bypass (CPB) in paediatric patients undergoing open heart surgery [2]. The PiCCO-Device (PulsecontourContinuousCardiacOutput) is well known as a semi-invasive method for the assessment of cardiac output, stroke volume variance (SVV), intrathoracic blood volume (ITBI) and extravascular lung water (EVLWI). In this study we investigated the effects of MUF performed after CPB on EVLWI as a parameter of pulmonary edema and on ITBI and SVV as parameters intravascular volume status. Methods: After approval by the local ethic committee and after parents’ written informed consent, 19 patients (age: 3.10.5) with minor congenital cardiac defects (ASD n=12; VSD n=7) were included into this study. The Children were monitored using a 3 Fr. PiCCO-catheter introduced via right femoral artery. General haemodynamic parameters and ITBI, EVLWI and SVV were obtained directly after discontinuation of CPB (Before MUF) as well as after a twenty minute period of MUF (After MUF). Students-t-test was used, p<0.05 was considered statistically significant; all data are expressed as mean ± sem. Results: In addition to the effects of MUF described previously [1,2] which were increases in mean arterial pressure and cardiac index and a reduction of inotropic support after MUF, we found the following changes: Conclusions: The MUF associated increase of ITBI and the significant decrease of SVV show, that haemodynamic improvement expressed by increases in mean arterial pressure and cardiac output could be due to an improvement of cardiac filling. The significant decrease of EVLWI suggests MUF to be a promising tool to prevent postoperative pulmonary edema with consecutive heart failure. References: [1] Naik SK, Knight A, Elliot MJ; Perfusion 1991(6):41-50 [2] Chew MS; Perfusion 2004(19):57-60

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