International Perfusion Association

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IPA

Category: Safety

EBCP 2024 Guidelines

2024 EACTS/EACTAIC/EBCP Guidelines on Cardiopulmonary Bypass in Adult Cardiac Surgery

The 2024 EACTS/EACTAIC/EBCP guidelines provide updated, evidence-based recommendations for cardiopulmonary bypass (CPB) in adult cardiac surgery. They cover advancements in perfusion strategies, organ protection, monitoring techniques, and safety measures. Key updates include AI-driven perfusion, enhanced neuromonitoring, and refined protocols for blood management and CPB separation. These guidelines aim to standardize practices, improve outcomes, and ensure patient safety in modern cardiac surgery.

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February 16, 2025
Lung Preservation

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

This expert consensus document from the American Association for Thoracic Surgery outlines standardized best practices for donor lung procurement and preservation. It highlights significant variability in existing techniques and emphasizes the role of ex vivo lung perfusion (EVLP), cold storage, and normothermic regional perfusion. The document provides 34 evidence-based recommendations aimed at improving organ utilization and lung transplant outcomes.

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February 6, 2025
Fluid Management in Adult Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation: A Scoping Review

Fluid Management in Adult Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation: A Scoping Review

This review explores fluid management in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). It highlights the lack of evidence for optimal fluid strategies, comparing liberal vs. restrictive approaches, or types like crystalloids and albumin. Fluid overload negatively affects survival and kidney outcomes, emphasizing the need for precise strategies. The study calls for rigorous research to determine effective fluid resuscitation approaches and improve clinical outcomes.

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December 24, 2024
Failure to Oxygenate During Cardiopulmonary Bypass: Treatment Options and Intervention Algorithm

Failure to Oxygenate During Cardiopulmonary Bypass: Treatment Options and Intervention Algorithm

This study addresses the critical issue of oxygenator failure during cardiopulmonary bypass (CPB), a rare but high-risk event. It explores protocols and techniques for addressing oxygenator malfunction, including traditional oxygenator change-outs and alternative approaches like arterial and venous piggyback methods. The authors emphasize the need for institutional preparation, including written protocols and routine emergency drills, and propose a venous piggyback technique as a safer first-line response to improve patient outcomes.

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December 23, 2024
Cerebral Perfusion

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Associated with Postoperative Delirium in Cardiac Surgery Patients: A Prospective Observational Study

This study investigates the relationship between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Despite reduced cortical metabolism, patients with POD exhibited increased cerebral blood flow, measured via transcranial Doppler. Low bispectral index (BIS) values indicated reduced metabolism, but no differences in autoregulation impairments were noted. The findings suggest a mismatch between cerebral blood flow and metabolism contributes to POD, independent of cerebral autoregulation.

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December 21, 2024
OR Ready

Global Perfusion Practice Survey: Readiness of On-Call and Emergency Operation Rooms

This survey examines the readiness of on-call and emergency operation rooms for perfusion-related procedures during urgent situations in cardiac surgery. Data from 236 healthcare professionals highlight varied preferences for circuit readiness, influenced by caseload, response times, and other factors. The study underscores the need for standardized protocols to enhance perfusion safety and improve patient care.

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August 5, 2024

Clinician Prediction of Survival vs Calculated Prediction Scores in Patients Requiring Extracorporeal Membrane Oxygenation

This study compares the accuracy of clinician predictions versus established prognostic scores in determining survival to hospital discharge for patients on extracorporeal membrane oxygenation (ECMO). Conducted from January 2020 to November 2021, the study involved interviews with nurses, perfusionists, and physicians within the first 24 hours of ECMO initiation. The results showed that clinicians, particularly perfusionists and physicians, had better prediction accuracy compared to the RESP and SAVE scores. The findings suggest the potential for developing more accurate prediction tools to guide ECMO eligibility.

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July 17, 2024
ECMO Safety

Sterility and Oxygenator Function in Pre-Primed Extracorporeal Membrane Oxygenation: A Prospective Clinical Study

This study explores the sterility and function of pre-primed extracorporeal membrane oxygenation (ECMO) circuits in a clinical setting. Conducted at Sahlgrenska University Hospital, the study assessed 107 ECMO circuits between 2019 and 2021, analyzing sterility through culture tests and oxygenator function through parameters like sweep gas flow and FiO2. Results indicated minimal bacterial growth and no significant impact of wet priming on oxygenator function, suggesting pre-priming is safe and effective for rapid ECMO initiation.

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July 2, 2024
Perform Report

Perfusion Measures and Outcomes (PERForm) Registry: First Annual Report

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.

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June 23, 2024
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