The use of ultrafiltration for inflammatory mediators removal during cardiopulmonary bypass in coronary artery bypass graf surgery Ultrafiltração para remover mediadores inflamatórios durante circulação extracorpórea na revascularização do miocárdio

AbstractObjective: To investigate the effectiveness ofultrafiltration in removing inflammatory mediators releasedby cardiopulmonary bypass and to correlate ultrafiltrationwith alterations in organic function according to theSequential Organ Failure Assessment Score. Methods: Forty patients were included and randomizedinto two groups: “no ultrafiltration” (n=20; Group I) and“ultrafiltration” (n=20; Group II). Activated complement 3and 4, interleukins 1beta, 6, 8 and tumor necrosis factoralfa were measured prior to anesthesia induction (Time 1),5 minutes before cardiopulmonary bypass (Time 2), in theultrafiltrated fluid (Time 3), 30 minutes (Time 4), and 6(Time 5), 12 (Time 6), 24 (Time 7), 36 (Time 8) and 48 (Time9) hours following cardiopulmonary bypass. SequentialOrgan Failure Assessment Score was evaluated at Time 1, 6and 9. Statistical significance was established at p ≤ 0.05. Results: In the ultrafiltrated fluid, only tumor necrosisfactor alfa levels were detected. Levels of activatedcomplement 3 at Times 5 and 7 and activated complement 4at Times 5 and 6 were significantly higher in the unfilteredGroup, and levels of interleukin 6 were higher in the filteredGroup at Times 7 and 8. Interleukins 1beta, 8, tumor necrosisfactor alfa, and the Sequential Organ Failure Assessmentscore were not significantly different between the groups.