2013 Volume 40 Issue 2 Pages 149-154
We developed an easy-to-use gravity drainage type hemodiafiltration method for correction of hyperkalemia(k≥ 5.5mmol/L)occurring during extracorporeal circulation in open heart surgery. The subjects of the present study were 11 consecutive patients(two men and nine women with a mean age of 63.6±12.9years)in whom this method was used for correction of hyperkalemia occurring during extracorporeal circulation. With the present method, substitution fluid(Sublood®-BSG)was perfused outside the hollow fiber hemoconcentrator(MAQUET BC140 plus®)by gravity counter-currently to the flow of blood, using a transfusion set(internal diameter of 3.0mm). The drop height was 150cm, and the blood flow rate was 400mL/min. The potassium added to the cardioplegic solution during extracorporeal circulation was 69.0±33.1mmol. Packed irradiated red blood cells, 5.5±3.6units, were transfused. Before applying this method, the maximum concentration of potassium was 6.41±0.76mmol/L. After its application, there was a significant decrease to 4.82±0.22mmol/L(p<0.0001)by the time of weaning from extracorporeal circulation. There were no significant differences in the concentrations of sodium, potassium, bicarbonate ion, or hydrogen ion concentration indices between the time immediately after the start of extracorporeal circulation and the time immediately before weaning. We conclude this novel method to be useful for correction of hyperkalemia occurring during extracorporeal circulation.
