{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:19:34Z","timestamp":1790032774648,"version":"4.0.1"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Cardiopulmonary bypass (CPB) requirement in infants presents a unique challenge because of the large prime volume\u2010to\u2010blood volume ratio. Packed red blood cells (PRBCs) tend to deteriorate with long\u2010term storage owing to their unphysiological composition and osmolality. Given that blood priming is inevitable in neonates, it is suggested that the metabolic load and osmolality are diminished before CPB initiation. We conducted the present study to test the hypothesis that the zero\u2010balance ultrafiltration (Z\u2010BUF) of the priming blood with 0.45% saline might be sufficient for modifying the metabolic load and osmolality and, thus, achieving a physiological state. Sixty infants with a weight below 10\u00a0kg undergoing CPB were randomly assigned either to a control group or to a Z\u2010BUF group and the Z\u2010BUF of the priming blood was performed in the latter group. Electrolytes and osmolality were measured in the priming blood. The bleeding volume, the blood transfusion rate, the length of mechanical ventilation, the length of stay in the intensive care unit (ICU), the body temperature, and renal biomarkers were compared between the 2 groups. The osmolality and the levels of potassium, sodium, glucose, chloride, and lactate in the priming blood were significantly decreased after Z\u2010BUF (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01). The Z\u2010BUF group showed significant reductions in postoperative blood loss; postoperative blood transfusion; time to extubation; the length of stay in the ICU; the levels of lactate, sodium, and blood urea nitrogen at 24\u00a0hours postoperatively and the body temperature at 18\u00a0hours postoperatively (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). However, no statistically significant differences were found between the 2 groups regarding the body temperature and the levels of serum creatinine and blood urea nitrogen after admission to the ICU. The results of the present study demonstrated that the Z\u2010BUF of the priming blood could be a useful strategy in infants undergoing CPB insofar as it significantly modified the composition of the priming blood and improved the clinical outcome among our patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.13559","type":"journal-article","created":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T14:32:25Z","timestamp":1566311545000},"page":"288-295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Zero\u2010balance ultrafiltration of the priming blood modifies the priming components and improves the clinical outcome in infants undergoing cardiopulmonary bypass: A randomized controlled trial"],"prefix":"10.1111","volume":"44","author":[{"given":"Maziar","family":"Gholampour Dehaki","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiac Surgery Rajaei Cardiovascular Medical and Research Center Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4108-280X","authenticated-orcid":false,"given":"Sana","family":"Niknam","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Development Unit of Besat Hospital Hamadan University of Medical Sciences Medical School Hamadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Bakhshandeh","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Rajaei Cardiovascular Medical and Research Center Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasoul","family":"Azarfarin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesia Rajaei Cardiovascular Medical and Research Center Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.13325"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1051\/ject\/201244060","article-title":"Modification of sodium, glucose, potassium, and osmolarity in packed red blood cells and fresh frozen plasma using a desktop hemoconcentrator setup","volume":"44","author":"Striker CW","year":"2012","journal-title":"J Extra Corpor Technol"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2008.179333"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12830"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2009.02549.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1051\/ject\/201446262","article-title":"Using zero balance ultrafiltration with 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