Division of Cardiovascular Perfusion, College of Health Professions, The Medical University of South Carolina Charleston SC 29425 USA.
Department of Cardiac Surgery, The Center for Healthcare Outcomes & Policy (CHOP), University of Michigan Medical School Ann Arbor MI 48109 USA.
J Extra Corpor Technol. 2023 Mar 24;55(1):3-22. doi: 10.1051/ject/2023002. eCollection 2023 Mar.
: Cardiovascular perfusion is a dynamic healthcare profession where new practices are frequently introduced. Despite the emergence of evidence-based clinical practice guidelines, little is known about their dissemination at the institutional level. Clinical practice surveys have been used to identify current trends in perfusion practice in the areas of equipment, techniques, and staffing. This survey aims to describe clinical perfusion practices across adult cardiac surgical programs located in a large, single, geographical region of the United States. : Following Institutional Review Board (IRB) approval, an 81-question survey was distributed to 167 adult perfusion programs across the Zone IV region of the American Society of Extracorporeal Technology (AmSECT), a non-profit professional society representing the extracorporeal technology community. Surveys were distributed to chief perfusionists through the Research Electronic Data Capture (REDCap) web-based survey response system. : Responses were received from 58 of 167 centers across (34.7% response rate). Centrifugal pumps were used at 81% ( = 47) of centers and 96.6% ( = 56) use an open venous system or hard-shell venous reservoir. Del Nido was the most frequently used cardioplegia strategy with 62.1% ( = 36) of centers reporting its use. The use of electronic medical records was reported in 43% ( = 25) of centers, while 84.5% ( = 49) reported using Cardiopulmonary Bypass (CPB) protocols (>75% of all CPB activities). Extracorporeal Membrane Oxygenation (ECMO) support was reported in 93.1% ( = 54) of programs, with 59.2% of programs ( = 34) employing a perfusionist as ECMO Coordinator. The + 1 staffing model was reported by 50% ( = 29), with 24% supporting the + 1 staffing for after-hours and on-call procedures. : Clinical practice surveys can be effective tools to inform clinicians about contemporary perfusion practice and identify deviations from professional standards and guidelines. Subsequent surveys may describe trends over time, assess standardization of practice, measure adherence to evidence-based guidelines, and foster improved patient care and outcomes.
心血管灌注是一个动态的医疗保健专业,经常引入新的实践。尽管出现了基于证据的临床实践指南,但对于它们在机构层面的传播情况知之甚少。临床实践调查已被用于确定在设备、技术和人员配备方面的灌注实践的当前趋势。本调查旨在描述位于美国一个大的单一地理区域的成人心脏外科项目中的临床灌注实践。
在美国体外技术协会(AmSECT)的第四区,经过机构审查委员会(IRB)批准,向 167 个成人灌注项目的首席灌注师分发了一份 81 个问题的调查问卷,AmSECT 是一个代表体外技术社区的非营利专业协会。调查问卷通过 Research Electronic Data Capture(REDCap)网络调查响应系统分发给首席灌注师。
共收到来自 167 个中心中的 58 个中心的回复(回应率为 34.7%)。81%(=47)的中心使用离心泵,96.6%(=56)使用开放式静脉系统或硬壳静脉储液器。Del Nido 是最常使用的心脏停搏液策略,有 62.1%(=36)的中心报告使用了该策略。43%(=25)的中心报告使用电子病历,而 84.5%(=49)的中心报告使用体外循环(CPB)方案(所有 CPB 活动的 75%以上)。93.1%(=54)的项目报告有体外膜氧合(ECMO)支持,其中 59.2%(=34)的项目由灌注师担任 ECMO 协调员。50%(=29)的中心报告采用了 1+1 人员配备模式,24%的中心为夜间和值班程序提供 1+1 人员配备。
临床实践调查可以成为向临床医生提供当代灌注实践信息并确定与专业标准和指南偏离的有效工具。随后的调查可能会描述随时间的趋势,评估实践的标准化程度,衡量对基于证据的指南的遵守情况,并促进改善患者护理和结果。