The first annual report of the Perfusion Measures and Outcomes (PERForm) registry details patient characteristics and cardiopulmonary bypass (CPB) practices from 2019 to 2022 across 42 hospitals. Covering data from 40,777 adult patients, the report highlights trends in myocardial protection, glucose, anticoagulation, temperature, anemia, and fluid management. Key findings include the stability of hematocrit levels and increased pump sucker termination before protamine administration, indicating improved compliance with evidence-based guidelines but identifying areas for enhanced patient safety.