Effect of combined Conventional Ultrafiltration and Modified Ultrafiltration on Serum Interleukin-6 and TNF-? Levels in Pediatric Cardiac Surgery Patients

AbstractBackground: Water retention occurs in most of the congenital heart surgery patients, especially in pediatrics. Ultrafiltration excretes water, electrolytes, many free radicals and inflammatory mediators. The aim of this study was to investigate the effect of modified ultrafiltration (MUF) on the serum levels of TNF-? and IL-6 in pediatrics patients undergoing congenital heart surgeries.Methods and Materials: A total of 91 pediatric congenital heart disease patients candidate for total correction were selected and divided randomly in two groups: CUF (Conventional Ultrafiltration) and CUF+MUF; 40 patients were allocated to CUF group and 51 patients to CUF+MUF group. Serum levels of TNF-? and IL-6 were assessed before CPB and 6 hours after the end of the operation in ICU. Postoperative levels of TNF-? and IL-6 were compared between the two groups.Results: In the MUF+CUF group, the preoperative and postoperative TNF-? levels were 2.5?5.6 and 1.4?3.0 respectively. However, IL-6 serum levels before and after operation were 4.8?8.9 and 41?56. In the CUF only group, the TNF-? level before and after surgery was 3.1?6.2 and 1.0?0.44; respectively; similarly, IL-6 serum levels were 3.3?8.2 and 34.8?37.7.Conclusion: MUF in congenital heart surgery could filtrate excess water and elevate hematocrit but does not have a definitive role in reducing TNF-? and IL-6 serum levels.Keywords: MUF, TNF-?, IL-6, CUF, cardiopulmonary bypass