Blood Purification for Perioperative Management of Cardiac Surgery

Abstract

The important roles of blood purification for perioperative management of cardiac surgery include i) management of hemodialysis-dependent patients with end-stage renal failure using intraoperative ultrafiltration and simplified intermittent hemodialysis, ii) management of the patients with acute kidney injury after cardiac surgery using continuous or intermittent renal replacement therapy (RRT), iii) intraoperative management of in/out fluid balance using aggressive dilutional ultrafiltration during cardiopulmonary bypass for all patients, and iv) improvement of fluid overload and edema using RRT after surgery. Of these, postoperative RRT should be performed to support organ functions, guided by the goals to correct electrolyte disturbance and acidemia, to reduce hyperkalemia, to remove fluid overload, and to improve hemodynamic stability.