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The Use of Ultrafiltration in High-Risk Post-operative Coronary Artery Bypass Grafting Patients.
  • +4
  • Daniel Beckles,
  • Giuseppe Tavilla,
  • Amber Malhotra,
  • Nikki E. Williams,
  • Tamara Jackson,
  • Michael Koerner,
  • Ramachandra Reddy
Daniel Beckles
Baylor Scott and White Central Texas

Corresponding Author:[email protected]

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Giuseppe Tavilla
Baylor Scott and White Central Texas
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Amber Malhotra
Baylor Scott and White Central Texas
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Nikki E. Williams
Baylor Scott and White Central Texas
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Tamara Jackson
Baylor Scott and White Central Texas
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Michael Koerner
Baylor Scott and White Central Texas
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Ramachandra Reddy
Baylor Scott and White Central Texas
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Abstract

Abstract: Background: Fluid overload (FO) and acute kidney injury (AKI) after CABG surgery are due to multiple perioperative etiologies associated with high failure to rescue rates (FTR) and associated with poor outcomes  1-,3. Diuretics, fluid restriction, ultrafiltration (UF) and renal replacement therapies are the treatment modalities implemented as monotherapy or in combination to address this severe complication. There is limited data on the use of simplified UF therapy as a fluid management strategy in post-operative cardiac surgery patients. Methods: A retrospective review of our post operative isolated CABG patients was done from Jan 1 st, 2020 to July 31 st, 2021. Those subjected to a simplified UF protocol incorporating Goal Directed Therapy (GDT) to treat fluid overload and/or acute kidney injury were evaluated for 30-day survival and readmission rates. Results: A total of 254 isolated CABG procedures were performed during this period. Ultrafiltration was used in 17 (6.7%) patients. The 30-day mortality for the entire CABG cohort was 5/254 (2.0%) patients and in the UF group 0/17 (0%). The mean age of UF therapy patients was 65.8 years (Range 41-89). The mean Society of Thoracic Surgeons STS mortality score of UF patients was 5.7% (Range 0.6-50.0). The 30-day survival for the 17 patients placed on UF therapy was 100% and their readmission rate was 2/17 (11.7%). Conclusions: The use of ultrafiltration in this patient population with relatively high STS scores provided a safe and effective modality to manage fluid balance but further studies are needed.
20 Jan 2022Submitted to Journal of Cardiac Surgery
20 Jan 2022Submission Checks Completed
20 Jan 2022Assigned to Editor
05 Feb 2022Reviewer(s) Assigned
05 Feb 2022Review(s) Completed, Editorial Evaluation Pending
13 Feb 2022Editorial Decision: Revise Major
03 Mar 20221st Revision Received
04 Mar 2022Submission Checks Completed
04 Mar 2022Assigned to Editor
04 Mar 2022Reviewer(s) Assigned
09 Mar 2022Review(s) Completed, Editorial Evaluation Pending
10 Mar 2022Editorial Decision: Revise Major
11 Apr 20222nd Revision Received
12 Apr 2022Submission Checks Completed
12 Apr 2022Assigned to Editor
12 Apr 2022Reviewer(s) Assigned
20 Apr 2022Review(s) Completed, Editorial Evaluation Pending
21 Apr 2022Editorial Decision: Revise Minor
21 May 20223rd Revision Received
25 May 2022Submission Checks Completed
25 May 2022Assigned to Editor
25 May 2022Review(s) Completed, Editorial Evaluation Pending
21 Jun 2022Editorial Decision: Revise Minor
15 Jul 20224th Revision Received
18 Jul 2022Submission Checks Completed
18 Jul 2022Assigned to Editor
18 Jul 2022Review(s) Completed, Editorial Evaluation Pending
03 Aug 2022Editorial Decision: Accept