{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:07:02Z","timestamp":1789474022708,"version":"build-2803163510"},"reference-count":17,"publisher":"EDP Sciences","issue":"3","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Extra Corpor Technol","JECT"],"accepted":{"date-parts":[[2026,5,18]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    <jats:italic>Background:<\/jats:italic>\n                    Hemofiltration during pediatric cardiopulmonary bypass (CPB) is essential to mitigate hemodilution, inflammatory responses, and postoperative complications. Conventional ultrafiltration (CUF) is widely practiced, but novel methods such as subzero balanced ultrafiltration combined with simple modified ultrafiltration (SBUF-SMUF) may offer superior outcomes.\n                    <jats:italic>Objective:<\/jats:italic>\n                    To compare the clinical efficacy and safety of CUF versus SBUF-SMUF in pediatric patients undergoing open-heart surgery.\n                    <jats:italic>Methods:<\/jats:italic>\n                    In this prospective randomized, outcome-assessor-blinded clinical trial, 80 pediatric patients with congenital heart disease were allocated to either CUF (\n                    <jats:italic>n<\/jats:italic>\n                    = 40) or SBUF-SMUF (\n                    <jats:italic>n<\/jats:italic>\n                    = 40) during CPB. Baseline demographics, intraoperative characteristics, fluid balance, blood product utilization, and postoperative outcomes were assessed. Statistical analysis was conducted using independent\n                    <jats:italic>t<\/jats:italic>\n                    -tests, Chi-square tests, and Fisher\u2019s exact tests. Statistical significance was defined as a two-tailed\n                    <jats:italic>p<\/jats:italic>\n                    -Value of less than 0.05.\n                    <jats:italic>Results:<\/jats:italic>\n                    Demographic and preoperative variables were comparable between groups. Mean fluid balance was significantly positive in the CUF group (+192.1 \u00b1 178.8 mL) but negative in the SBUF-SMUF group (\u2013105.0 \u00b1 78.9 mL,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). The SBUF-SMUF group required significantly less intraoperative PRBC (141.7 \u00b1 70.2 vs. 261.0 \u00b1 68.8 mL,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001) and postoperative FFP transfusion (2% vs. 10%,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.020). Post-bypass hematocrit levels were higher (31.2% vs. 27.3%,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001) and extubation occurred earlier in the SBUF-SMUF group (1.05 \u00b1 1.03 vs. 2.27 \u00b1 2.37 days,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.006). No significant differences were observed in potassium levels or incidence of acute kidney injury.\n                    <jats:italic>Conclusion:<\/jats:italic>\n                    The SBUF-SMUF technique is safe, effective, and superior to CUF in optimizing fluid balance, reducing blood product utilization, and facilitating earlier extubation in pediatric cardiac surgery. No additional risk of oliguria or electrolyte imbalance was observed compared to CUF. Its simplicity and reproducibility support its consideration as a standard approach in pediatric CPB.\n                  <\/jats:p>","DOI":"10.1051\/ject\/2026020","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T18:46:11Z","timestamp":1779648371000},"page":"228-236","source":"Crossref","is-referenced-by-count":0,"title":["SBUF-SMUF: On the path to the optimum hemofiltration technique in pediatric cardiopulmonary bypass: A randomized clinical trial"],"prefix":"10.1051","volume":"58","author":[{"given":"Mehrtash","family":"Shadmehr","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babar","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Perfusion, Khyber Medical University","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Abdollahzadeh","sequence":"additional","affiliation":[{"name":"Department of Perfusion, School of Medicine, Isfahan University of Medical Science","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Zarrabi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, School of Medicine, Shiraz University of Medical Science","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Gerami","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Sciences","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman Parvaiz","family":"Butt","sequence":"additional","affiliation":[{"name":"Perfusion Services, Heart Vascular and Thoracic Institute","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Johnson A, Hessel EA. An overview of cardiopulmonary bypass\u2019s historic development. In: Clinical Perfusion for Cardiac Surgery: A Step-by-Step Guide to the Fundamentals. Springer Nature Switzerland AG; 2025;53\u201360.","DOI":"10.1007\/978-3-031-91163-7_5"},{"issue":"9","key":"R2","doi-asserted-by":"crossref","first-page":"e010657","DOI":"10.1161\/CIRCOUTCOMES.123.010657","volume":"17","author":"Parker","year":"2024","journal-title":"Circ Cardiovasc Qual Outcomes."},{"issue":"4","key":"R3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s12098-019-03133-w","volume":"87","author":"Arvind","year":"2020","journal-title":"Indian J Pediatr."},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Matte GS, Kwon M, Mayer JE Fundamentals of cardiopulmonary bypass for congenital heart surgery. In: Nadas\u2019 Pediatric Cardiology. Elsevier; 2025;719\u201330.","DOI":"10.1016\/B978-1-4557-0599-3.00069-7"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Manrique AM, Vargas DP, Palmer D, Kelly K, Litchenstein SE. The effects of cardiopulmonary bypass following pediatric cardiac surgery. In: Critical Care of Children with Heart Disease: Basic Medical and Surgical Concepts. Springer; 2020; 113\u201329.","DOI":"10.1007\/978-3-030-21870-6_10"},{"issue":"4","key":"R6","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1111\/trf.16844","volume":"62","author":"Mladinov","year":"2022","journal-title":"Transfusion."},{"issue":"4","key":"R7","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1177\/02676591231157970","volume":"39","author":"Hensley","year":"2024","journal-title":"Perfusion."},{"issue":"6","key":"R8","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1177\/2150135119870176","volume":"10","author":"Bierer","year":"2019","journal-title":"World J Pediatr Congenit Heart Surg."},{"issue":"8","key":"R9","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1177\/02676591211027788","volume":"37","author":"Bierer","year":"2022","journal-title":"Perfusion."},{"issue":"2","key":"R10","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/bdra.23111","volume":"97","author":"Bjornard","year":"2013","journal-title":"Birth Defects Res A Clin Mol Teratol."},{"issue":"6","key":"R11","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1007\/s00467-020-04489-4","volume":"35","author":"Bellos","year":"2020","journal-title":"Pediatr Nephrol."},{"key":"R12","doi-asserted-by":"crossref","first-page":"602034","DOI":"10.3389\/fped.2021.602034","volume":"9","author":"Niu","year":"2021","journal-title":"Front Pediatr."},{"issue":"1","key":"R13","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1051\/ject\/202153027","volume":"53","author":"Stammers","year":"2021","journal-title":"J Extra Corpor Technol."},{"issue":"2","key":"R14","first-page":"6","volume":"18","author":"Ziyaeifard","year":"2017","journal-title":"Iran Heart J."},{"issue":"7","key":"R15","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1097\/PCC.0000000000000178","volume":"15","author":"T\u00fcrk\u00f6z","year":"2014","journal-title":"Pediatr Crit Care Med."},{"issue":"3","key":"R16","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0022-5223(98)70313-7","volume":"115","author":"Bando","year":"1998","journal-title":"J Thorac Cardiovasc Surg."},{"issue":"8","key":"R17","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1159\/000520519","volume":"51","author":"Bhatt","year":"2022","journal-title":"Blood Purif."}],"container-title":["The Journal of ExtraCorporeal Technology"],"original-title":[],"link":[{"URL":"https:\/\/ject.edpsciences.org\/10.1051\/ject\/2026020\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:46:18Z","timestamp":1789472778000},"score":1,"resource":{"primary":{"URL":"https:\/\/ject.edpsciences.org\/10.1051\/ject\/2026020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":17,"journal-issue":{"issue":"3"},"alternative-id":["ject250096"],"URL":"https:\/\/doi.org\/10.1051\/ject\/2026020","relation":{},"ISSN":["0022-1058","2969-8960"],"issn-type":[{"value":"0022-1058","type":"print"},{"value":"2969-8960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}