Adult Clinical Perfusion Practice Survey: 2020 results.

Abstract

Background: 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. Methods: 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. Results: Responses were received from 58 of 167 centers across (34.7% response rate). Centrifugal pumps were used at 81% (n = 47) of centers and 96.6% (n = 56) use an open venous system or hard-shell venous reservoir. Del Nido was the most frequently used cardioplegia strategy with 62.1% (n = 36) of centers reporting its use. The use of electronic medical records was reported in 43% (n = 25) of centers, while 84.5% (n = 49) reported using Cardiopulmonary Bypass (CPB) protocols (>75% of all CPB activities). Extracorporeal Membrane Oxygenation (ECMO) support was reported in 93.1% (n = 54) of programs, with 59.2% of programs (n = 34) employing a perfusionist as ECMO Coordinator. The n + 1 staffing model was reported by 50% (n = 29), with 24% supporting the n + 1 staffing for after-hours and on-call procedures. Conclusion: 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.