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Background: Expected benefits of modified ultrafiltration(MUF) include increased hematocrit, reduction of total body water & inflammatory mediators, improved left ventricular systolic function, & improved systolic blood pressure and cardiac index following cardiopulmonary bypass(CPB). This prospective randomized trial tested this hypothesis. Methods: 79 patients undergoing intracardiac repair of Tetralogy of Fallot(TOF) were randomized to MUF group(Group-M, n=39) or only conventional ultrafiltration(CUF) group(Group-C, n=40). Primary outcome was change in hematocrit. Secondary outcomes were changes in peak airway pressures, ventilatory support, blood transfusions, time to peripheral rewarming, mean arterial pressure, central venous pressure, inotrope score(IS) and cardiac index. Serum inflammatory markers were measured. Results: Following MUF, Group-M had higher hematocrit(44.3±0.98 g/dl) compared to Group-C(37.8±1.37g/dl),P=<0.001. Central venous pressure(mmHg) immediately following sternal closure was 9.27±3.12mmHg in Group-M & 10.52±2.2mmHg in Group-C(P=0.04). In the ICU, they were 11.52±2.20mmHg in Group-C and 10.84±2.78mmHg in Group-M(P=0.02). Time to peripheral rewarming was 6.30±3.91 hours in Group-M and 13.67±3.91hours in Group-C(P=0.06). Peak airway pressures in ICU were 17±2mmHg in Group-M & 20.55±2.97mmHg in Group-C, P<0.001. Duration of mechanical ventilation was 6.3±2.7 hours in Group-M compared to 14.7±3.5 hours in Group-C(P=0.002). IS was 11.52±2.20 in Group-C compared to 10.84±2.78 in Group-M. 8/39(20.5%) patients in Group-M had IS>10 compared to 22/40(55%) patients in Group-C(P=0.02). Serum Troponin-T and Interleukin-6 levels were lower in Group-M; TNF-α and CPK-MB were similar. ICU & hospital stay were similar. Conclusion: MUF group had higher post-operative hematocrit, decreased duration of mechanical ventilation, lower need for inotropes & lower Interleukin-6 & Troponin-T levels. MUF group had better post-operative outcomes.

Aims: To determine the prevalence of depression and anxiety in Indian patients undergoing CABG surgery and their relationship to physical activity and quality of life. Methods: 121 patients undergoing CABG surgery between November 2017 and May 2019 were included. The Hospital Anxiety and Depression Scale (HADS) was employed for the assessment of depression and anxiety. Health-related quality of life was assessed using the SF-36 questionnaire. The short form of the International Physical Activity Questionnaire (IPAQ) was used for assessment of physical activity. Participants were categorized into high, moderate or low physical activity. Results: The overall prevalence (95% CI) of depression and anxiety was 70.5% (0.61-0.78) and 64.6% (0.55-0.73) respectively. When a cut-off score of 11 instead of 8 was used on the HADS [Borderline cases excluded (HADS score 8-10)], the prevalence of depression and anxiety was 31.3% (0.22-0.40) and 40.7% (0.31-0.50) respectively. Patients with low levels of physical activity had a higher prevalence of depression and anxiety (p < 0.05). Patients with depression demonstrated a worse quality of life compared to those without depression in all domains measured by the SF-36 questionnaire. Among patients with anxiety, quality of life was worse in four out of the eight domains measured by the SF-36 questionnaire. Conclusion: Indian patients undergoing CABG surgery have a high prevalence of depression and anxiety. Patients with depression and anxiety were found to have low physical activity and poor quality of life when compared to their counterpart. Keywords: CABG; depression; anxiety; quality of life; physical activity.