International Perfusion Association

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IPA

Category: Safety

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
Kidney Protection

A Randomized Trial of Intravenous Amino Acids for Kidney Protection

This study investigated the efficacy of intravenous amino acids in reducing acute kidney injury (AKI) in patients undergoing cardiac surgery. A total of 3511 patients were randomized to receive either amino acids or a placebo. Results showed a significant reduction in AKI occurrence in the amino acid group (26.9%) compared to the placebo group (31.7%), with a relative risk of 0.85. The severity of AKI and the need for kidney-replacement therapy were also lower in the amino acid group. No major differences in other secondary outcomes or adverse events were observed.

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June 12, 2024
Easy Flow Simulation

Easy Flow: An Eclectic Cardiopulmonary Bypass Simulation Model

The “Easy Flow Cardiopulmonary Bypass Simulation Model” offers a cost-effective, innovative approach to perfusion training using standard CPB equipment found in operating rooms. Unique features include double reservoirs and two pumps, enhancing skill development, team management, communication, and disaster response training. This model, requiring an instructor, turns theoretical knowledge into practical competence, making it accessible and beneficial for global healthcare education.

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June 11, 2024
ECMO Team

Psychological Safety in an ECMO Retrieval Team: A Qualitative Study to Inform Improvement

This study explores psychological safety within an ECMO retrieval team at the Royal Brompton Hospital in London. By conducting semistructured interviews with consultants, nurses, and perfusionists, researchers identified factors influencing psychological safety. Key findings include the impact of the high-risk environment, structured team processes, and leadership behaviors on team communication and collaboration. Recommendations were made to enhance psychological safety by addressing these factors.

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June 1, 2024

Hospital Readmissions in Patients Supported with Durable Centrifugal-Flow Left Ventricular Assist Devices

The study examines hospital readmissions in patients with centrifugal-flow left ventricular assist devices (CF-LVADs), highlighting the commonality and impact on patient outcomes. Analyzing data from 204 patients, 67.7% experienced heart failure (HF)/LVAD-related readmissions, mainly due to major bleeding, infection, HF exacerbation, and neurological dysfunction. Using machine learning models, several pre-, intra-, and post-operative factors were identified as predictors of readmission risk, which can guide strategies to improve patient management and outcomes.

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May 28, 2024
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