High-exchange ULTrafiltration to enhance Recovery After pediatric cardiac surgery (ULTRA): A Randomized Controlled Trial

Congenital heart disease, occurring in roughly 1% of all newborns, is when babies have defects in their heart chambers, walls, or valves. These malformations can cause symptoms in the child, such as trouble breathing, feeding, or growing and, if left untreated, many children pass away. Heart surgery is often needed to fix the problem. During the surgery, the heart-lung machine allows surgeons to see and fix defects within the heart. However, the machine causes significant inflammation affecting the function of the body's organs - usually the heart, lungs, kidneys, and brain. This in return, leads to a slow recovery after surgery and prolonged stays in the hospital. In rare cases, this inflammation can even contribute to the risk of death from the surgery. Ultrafiltration was developed to improve recovery after children's heart surgery. It "cleans" the blood by removing excess water and inflammatory factors during surgery. There are many ways to ultrafiltrate; however, it is not known which type is best for babies and children with congenital heart disease. Subzero-balance and simple modified ultrafiltration (SBUF-SMUF) is one example of ultrafiltration. Our research has suggested that SBUF-SMUF could be the most effective technique and we have demonstrated that it removes 21 inflammatory factors continuously during surgery. "Inflammation and Ultrafiltration: Enhancing Recovery after Pediatric Cardiac Surgery" seeks to prove that SBUF-SMUF enhances recovery for babies and children undergoing heart surgery. Enhanced recovery translates to medical stability after surgery, lessens the time spent in the intensive care unit and hospital. Ultimately, this allows the child and the whole family to return to a normal lifestyle earlier. This SBUF-SMUF technique is replicable, and thus, our research has the potential to improve outcomes for all children needing heart surgery in Canada.