Zero balance ultrafiltration for the correction of acute acidosis after a period of prolonged deep hypothermic circulatory arrest

• Published in: Perfusion Vol. 27; no. 1; pp. 9 - 11
• Main Authors: Mick, S, Hilberath, JN, Davidson, MJ, FitzGerald, D
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-01-2012; Sage Publications Ltd
• Subjects: Acid-Base Equilibrium; Acidosis - etiology; Acidosis - therapy; Acute Disease; Adult; Aorta, Thoracic - surgery; Aortic Diseases - surgery; Cardiopulmonary Bypass - adverse effects; Female; Humans; Hypothermia, Induced - adverse effects; Time Factors; Treatment Outcome; Ultrafiltration - methods; Water-Electrolyte Balance; acid-base correction; deep hypothermic circulatory arrest; total aortic arch replacement; zero balance ultrafiltration; PrismaSate
• ISSN: 0267-6591; 1477-111X
• DOI: 10.1177/0267659111419886

A 36-year-old woman with normal renal function underwent a total arch replacement requiring 110 minutes of deep hypothermic circulatory arrest. Prior to rewarming, a pH of 7.063 with a base deficit of 10.8 was obtained. Zero-balance ultrafiltration (Z-BUF) was initiated during rewarming 7 minutes after resumption of cardiopulmonary bypass. After one hour (10L) of Z-BUF, all electrolyte and acid-base disturbances were fully corrected. Our case illustrates that Z-BUF offers a valuable option for the correction of severe electrolyte and acid-base disturbances in adults undergoing cardiac surgery. Its use should be considered in addition to the more standard pharmacologic approaches to such derangements as it offers rapid and predictable electrolyte and acid-base correction and potential anti-inflammatory benefits.