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Application Effect of Balanced Ultrafiltration Technique in the Treatment of Pediatric Congenital Heart Disease by Direct Intracardiac Surgery under Extracorporeal Circulation |
YIN Jihui |
First-author's address: Tai’an Maternity and Child Health Hospital, Shandong Province, Tai’an 271000, China |
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Abstract Objective: To investigate the application effect of balanced ultrafiltration technique in the treatment of pediatric congenital heart disease by direct intracardiac surgery under extracorporeal circulation. Method: A total of 86 children with congenital heart disease treated in Tai’an Maternity and Child Health Hospital from January 2021 to December 2022 were selected and divided into control group (n=43) and observation group (n=43) by random number table method. The control group received conventional ultrafiltration, and the observation group received balanced ultrafiltration. Interleukin-6 (IL-6), interleukin-10 (IL-10) and hypersensitive C reactive protein (hs-CRP) were compared between the two groups at different times [before cardiopulmonary bypass (T0), immediately after ultrafiltration (T1), 24 h after surgery (T2), 48 h after surgery (T3), 72 h after surgery (T4)]; the pulmonary function [(P(A-a)O2, pulmonary artery pressure (PAP)] of the two groups were compared before, immediately after surgery, 24 h after surgery and 48 h after surgery; the postoperative recovery (the time of using vasoactive drugs, the time of using ventilator, and the length of ICU stay) of the two groups of children were compared surgery. Result: T0, IL-6, IL-10, hs-CRP levels between the two groups were not statistically significant (P>0.05); the levels of IL-6 at T1, T2, T3 and T4 in both groups were higher than those at T0, and the levels of IL-6 at T2, T3 and T4 in observation group were lower than those in control group, the differences were statistically significant (P<0.05); the IL-10 levels at T1, T2, T3 and T4 in two groups were higher than those at T0, and the IL-10 levels at T1, T2, T3 and T4 in observation group were lower than those in control group, the differences were statistically significant (P<0.05); the hs-CRP levels at T1, T2, T3 and T4 were higher than those at T0, and the hs-CRP levels at T2, T3 and T4 in observation group were lower than those in control group, the differences were statistically significant (P<0.05). Before operation, there were no significant differences in P(A-a)O2 and PAP between the two groups (P>0.05); P(A-a)O2 were higher than T0 immediately after surgery, 24 h after surgery and 48 h after surgery in both groups, but P(A-a)O2 in observation group were lower than those in control group, the differences were statistically significant (P<0.05); immediately after surgery, 24 h after surgery and 48 h after surgery, PAP in both groups were lower than those at T0, and PAP in observation group were lower than those of the control group, the differences were statistically significant (P<0.05). The time of vasoactive drug use, ventilator use and ICU stay in the observation group were shorter than those in the control group, the differences were statistically significant (P<0.05). Conclusion: In children with congenital heart disease, there will be inflammation in the body during open heart surgery, balanced ultrafiltration technology can reduce the inflammation, reduce the injury, protect the lung function and promote the postoperative recovery of the children.
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Received: 01 July 2023
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