Podcast
Questions and Answers
What did Thomas Graham present a paper on in 1854?
What did Thomas Graham present a paper on in 1854?
- Artificial kidney
- Dialysis procedure
- Anticoagulant derived from leeches
- Osmotic Force (correct)
What is the pressure gradient that transmembrane pressure (TMP) should not exceed?
What is the pressure gradient that transmembrane pressure (TMP) should not exceed?
- 1000-1200 mm Hg
- 700-800 mm Hg
- 500-600 mm Hg (correct)
- 200-300 mm Hg
Who conducted the first clinical dialysis procedure in 1924?
Who conducted the first clinical dialysis procedure in 1924?
- George Haas (correct)
- Leonard Skeggs
- Willem Kolff
- Richard Stewart
What does the sieving coefficient, ranging from 0 to 1.0, indicate?
What does the sieving coefficient, ranging from 0 to 1.0, indicate?
What material did Willem Kolff use to build an artificial kidney in the 1940s?
What material did Willem Kolff use to build an artificial kidney in the 1940s?
What does ultrafiltration remove in equal concentration to the plasma water?
What does ultrafiltration remove in equal concentration to the plasma water?
Who developed the flat or parallel plate dialyzer in 1947?
Who developed the flat or parallel plate dialyzer in 1947?
What does ultrafiltration during cardiopulmonary bypass (CPB) particularly help with?
What does ultrafiltration during cardiopulmonary bypass (CPB) particularly help with?
How is ultrafiltration achieved?
How is ultrafiltration achieved?
What factors determine the rate of fluid removal during ultrafiltration?
What factors determine the rate of fluid removal during ultrafiltration?
What occurs during ultrafiltration in terms of solute removal?
What occurs during ultrafiltration in terms of solute removal?
What is the hemoconcentrator or ultrafiltrator configured in parallel to?
What is the hemoconcentrator or ultrafiltrator configured in parallel to?
What type of membrane material is commonly used in ultrafiltration during dialysis?
What type of membrane material is commonly used in ultrafiltration during dialysis?
When is a flowmeter recommended for more precise measurements during ultrafiltration?
When is a flowmeter recommended for more precise measurements during ultrafiltration?
What is the definition of ultrafiltration?
What is the definition of ultrafiltration?
What are ultrafiltration and dialysis primarily utilized to manage in patients undergoing CPB?
What are ultrafiltration and dialysis primarily utilized to manage in patients undergoing CPB?
How do hemoconcentrators impact circulating concentrations of drugs and ions?
How do hemoconcentrators impact circulating concentrations of drugs and ions?
What do several studies suggest about the impact of ultrafiltration and dialysis on the systemic inflammatory response syndrome (SIRS)?
What do several studies suggest about the impact of ultrafiltration and dialysis on the systemic inflammatory response syndrome (SIRS)?
What is the primary difference between ultrafiltration and dialysis?
What is the primary difference between ultrafiltration and dialysis?
What creates a solute concentration gradient across the membrane during ultrafiltration?
What creates a solute concentration gradient across the membrane during ultrafiltration?
What is the primary purpose of ultrafiltration during cardiopulmonary bypass (CPB)?
What is the primary purpose of ultrafiltration during cardiopulmonary bypass (CPB)?
What is the purpose of continuous ultrafiltration during rewarming on CPB?
What is the purpose of continuous ultrafiltration during rewarming on CPB?
What is the role of Z-BUF (Zero-Balance Ultrafiltration) in adults undergoing cardiac surgery?
What is the role of Z-BUF (Zero-Balance Ultrafiltration) in adults undergoing cardiac surgery?
What is the purpose of Modified Ultrafiltration (MUF) in pediatric patients post-CPB?
What is the purpose of Modified Ultrafiltration (MUF) in pediatric patients post-CPB?
What can ultrafiltration remove from the blood during cardiopulmonary bypass (CPB)?
What can ultrafiltration remove from the blood during cardiopulmonary bypass (CPB)?
How does Z-BUF ensure stable potassium levels during ultrafiltration?
How does Z-BUF ensure stable potassium levels during ultrafiltration?
Why may protamine not be administered during Modified Ultrafiltration (MUF)?
Why may protamine not be administered during Modified Ultrafiltration (MUF)?
What challenges presented by cardiopulmonary bypass (CPB) can be addressed through ultrafiltration?
What challenges presented by cardiopulmonary bypass (CPB) can be addressed through ultrafiltration?
How does Z-BUF contribute to post-CPB outcomes?
How does Z-BUF contribute to post-CPB outcomes?
What can ultrafiltration efficiently remove compared to dialysis?
What can ultrafiltration efficiently remove compared to dialysis?
Study Notes
Ultrafiltration and Modified Ultrafiltration in Cardiopulmonary Bypass
- Ultrafiltration during cardiopulmonary bypass (CPB) aims to remove excess water, concentrate cellular elements, and proteins in the blood, while maintaining the patient's plasma concentration of diffusible solutes.
- Continuous ultrafiltration during rewarming on CPB may attenuate the inflammatory response, as it can lower cytokine and complement levels, especially during this phase.
- To enable continuous ultrafiltration during rewarming, ultrafiltrate is replaced with a balanced electrolyte solution.
- Z-BUF (Zero-Balance Ultrafiltration) has been used to correct hyperkalemia, electrolyte, and acid-base disturbances in adults undergoing cardiac surgery.
- Z-BUF ensures that as blood volume is reduced by ultrafiltration, potassium levels remain stable, as ultrafiltrate potassium levels are always in equal concentration to the plasma.
- Modified Ultrafiltration (MUF) is a procedure used in pediatric patients to concentrate and transfuse residual circuit blood post-CPB without the risk of hypervolemia.
- MUF requires patients to remain cannulated for 10 to 20 minutes post-CPB termination, and protamine may not be administered during MUF to maintain circuit integrity.
- Ultrafiltration can remove direct thrombin inhibitors like bivalirudin, with the potential to remove 45% to 65% of the drug using MUF or UF for adults.
- CPB presents challenges in managing hemodilution, electrolyte levels, and fluid shifts due to the systemic inflammatory response, all of which can be addressed through ultrafiltration.
- Z-BUF, in combination with MUF, has shown improved post-CPB outcomes and reduced levels of inflammatory mediators.
- The conventional dialysis circuit can be simplified for use in the extracorporeal circuit to manage patient volume and electrolyte imbalances, similar to Z-BUF or hemofiltration.
- Ultrafiltration appears to efficiently remove middle-molecule uremic solutes compared to dialysis.
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Test your knowledge of ultrafiltration and modified ultrafiltration in cardiopulmonary bypass with this quiz. Explore the uses, benefits, and techniques of ultrafiltration in managing hemodilution, electrolyte levels, and fluid shifts during CPB, as well as the application of Z-BUF and MUF in improving post-CPB outcomes.
