Zero Balance versus Conventional Hemofiltration-Impact on Renal Function and Blood Conservation in Adult Valvular

Abstract

Aim: To compare conventional ultrafiltration (CUF) with zero-balanced ultrafiltration (Z-BUF) in the patients having valvular heart surgery. Methods: This cross-sectional mono-centered retrospective study was designed. The data of total 471 patients were reviewed during March 2018 to February 2020, only 98 patients fitted in the inclusion criteria and were divided into two groups with 47(47.95%) patients received CUF, while 51 (52.04%) patients were administered with Z-BUF at the Department of Cardiovascular Surgery, King Edward Medical University, Lahore, Pakistan. Statistical analysis was done using SPSS version 25. The early postoperative clinical outcomes included, renal function as primary outcome and hemodynamics stability of the patients as secondary outcome. Results: Renal functions in terms of serum creatinine (1.1 vs. 1.3mg/dL; P < 0.010) and creatinine clearance ratio (81.51vs. 67.3mL/min; P < 0.01) were improved in the patients having Z-BUF compared with CUF. Urine output was almost double in the Z-BUF cohort compared with the CUF. The hemofiltration technique had no impact on the secondary outcomes as amount of the blood loss and number of patients required blood transfusion were similar (P > 0.05) in our cohort. Conclusion: Z-BUF appeared to be better hemofiltration method than CUF during CPB when assessed in terms of renal protection without hemodynamic status in patients undergoing valvular heart surgeries in our population. Keywords: Cardiopulmonary bypass, Ultrafiltration, Renal injury, Hemoglobin, Blood transfusion