Itoh H, Sano S, Pouard P
Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.
Perfusion. 2012 Jan;27(1):72-7. doi: 10.1177/0267659111424638. Epub 2011 Oct 17.
We report here Japan's first pediatric perfusion survey. It covers practices from January 2007 through December 2009. Of the 70 congenital heart centers contacted, 53 (76%) completed the survey. They reported performing 3,379 pediatric cardiopulmonary bypass (CPB) procedures in 2009, 3,408 in 2008, and 3,358 in 2007.Twenty-eight percent of all centers used CPB circuits with a priming volume between 151-200 ml. All centers used pre-bypass ultrafiltration and only 6% used retrograde autologous priming. A biomaterial-coated circuit was used by 78% of the centers, a roller pump as the arterial pump by 91%, vacuum-assisted venous drainage by 39%, dilutional ultrafiltration by 48%, and modified ultrafiltration at the end of the procedure by 30%. A regional oxygen saturation monitor was used by 69% of the centers and high flow (150-200 ml/kg/min) management with alpha-stat blood gas control was standard during moderate to normothermic CPBs. Crystalloid cardioplegia solution was used as myocardial protection by 56% of the centers, electronic recording of monitoring data by 51%. The centers performed 98 pediatric extracorporeal membrane oxygenation procedures in 2007, 109 in 2008, and 119 in 2009; 58% of the centers used a centrifugal pump. This survey provides a description of the current practice in Japan. Future surveys will identify trends and rate of change in practice.
我们在此报告日本首次儿科灌注调查。该调查涵盖了2007年1月至2009年12月期间的相关操作。在联系的70个先天性心脏病中心中,53个(76%)完成了调查。他们报告2009年进行了3379例儿科体外循环(CPB)手术,2008年为3408例,2007年为3358例。所有中心的28%使用预充量在151 - 200毫升之间的CPB回路。所有中心都使用体外循环前超滤,只有6%使用逆行自体预充。78%的中心使用生物材料涂层回路,91%使用滚压泵作为动脉泵,39%使用真空辅助静脉引流,48%使用稀释性超滤,30%在手术结束时使用改良超滤。69%的中心使用区域血氧饱和度监测仪,在中度至常温CPB期间,采用α稳态血气控制的高流量(150 - 200毫升/千克/分钟)管理是标准操作。56%的中心使用晶体心脏停搏液作为心肌保护,51%对监测数据进行电子记录。这些中心在2007年进行了98例儿科体外膜肺氧合手术,2008年为109例,2009年为119例;58%的中心使用离心泵。本次调查描述了日本目前的实践情况。未来的调查将确定实践中的趋势和变化率。