PCN-GDP Practice Survey

Cardiopulmonary Bypass (CPB) Practice Survey for Adult Patients

INVESTIGATORS: Perfect Care Impact Network (PCIN) comprised of perfusion partners from Virginia Cardiac Services Quality Initiative (VCSQI), Maryland Cardiac Surgery Quality Initiative (MCSQI), and Perfect Care of North Carolina (PC of NC).

The PCIN perfusion partners are collaborating to assess current practices and adherence to AMSECT standards and guidelines for adult CPB within the tri-state area. It aims to gather insights on perfusion techniques, equipment usage, and clinical decision-making processes within your team. The results will contribute to the development of a regional perfusion database through the PCIN and to support evidence-based improvements in patient care. Please answer each question based on your team’s experience and practices for adult patients only.

1.Contact Information(Required.)

Name

Facility/Site

2.How many adult pump cases does your team perform each year?

Up to 200 cases per year

200-400 cases per year

More than 400 per year

3.Do you use DO2 as a measure of perfusion adequacy on pump?

AMSECT Standards and Guidelines for Perfusion Practice, February 2023: Standard 9.2.

STS/SCA/AmSect Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery-Associated Acute Kidney Injury, J Extra Corpor Technol. 2022;54:267-90, Class I, Level B-R

Always

Sometimes

Never

4.Do you practice ANH?

STS/SCA/AmSect/SABM Update to the Clinical Practice Guidelines on Patient Blood Management, Ann Thorac Surg.2021;112:981-1004, Perfusion Interventions, Class IIa, Level A

Always (>= 90% cases)

Usually (60-90% cases)

Seldom (20-50% cases)

Never

5.Do you RAP your circuit?

AMSECT Standards and Guidelines for Perfusion Practice, February 2023: Guideline 13.1.

STS/SCA/AmSect/SABM Update to the Clinical Practice Guidelines on Patient Blood Management, Ann Thorac Surg.2021;112:981-1004, Perfusion Interventions, Class I, Level B-R

Always (>= 90% cases)

Usually (60-90% cases)

Seldom (20-50% cases)

Never

6.Do you measure cerebral oximetry intraoperatively?

AMSECT Standards and Guidelines for Perfusion Practice, February 2023: Guideline 7.5.

VCSQI, AKI Reduction Recommendations and Suggestions for Care, 12/9/2023, Intraoperative Cardiac Surgery Recommendations

Always (>= 90% cases)

Usually (60-90% cases)

Seldom (20-50% cases)

Never

7.Do you use a hemoconcentrator on bypass?

AMSECT Standards and Guidelines for Perfusion Practice, February 2023: Guideline 13.1

Always (>= 90% cases)

Usually (60-90% cases)

Seldom (20-50% cases)

Never

8.Which of the following statements most closely aligns with your practice?
We use a hemoconcentrator _______________________.

STS/SCA/AmSect/SABM Update to the Clinical Practice Guidelines on Patient Blood Management, Ann Thorac Surg.2021;112:981-1004, Use of modified ultrafiltration, Class IIB, Level B-R.

AMSECT Standards and Guidelines for Perfusion Practice, February 2023: Guideline 13.1

Only during CPB

Both during CPB and after CPB to reduce residual pump blood volume

Only after CPB to reduce residual pump blood volume

Other (please specify)

9.During CPB, our transfusion trigger is ______________.

STS/SCA/AmSect/SABM Update to the Clinical Practice Guidelines on Patient Blood Management, Ann Thorac Surg.2021;112:981-1004, Transfusion algorithms, Class I, Level A

Hgb <8

Hgb <7

Hgb <6

No set transfusion trigger

10.Do you incorporate POC viscoelastic devices (i.e. TEG, Rotem, Hemosonics Quantra) in your transfusion algorithm?

STS/SCA/AmSect/SABM Update to the Clinical Practice Guidelines on Patient Blood Management, Ann Thorac Surg.2021;112:981-1004, Transfusion algorithms, Class I, Level B-R.

AMSECT Standards and Guidelines for Perfusion Practice, February 2023: Guideline 13.2

Always (>= 90% cases)

Usually (60-90% cases)

Seldom (20-50% cases)

Never