Adult cardiopulmonary bypass in Australian and New Zealand public hospitals: A survey of practice

Anaesthesia and Intensive Care
Simon J Pattullo, David M Samson

Abstract

A telephone survey of cardiac anaesthetists and perfusionists at the 29 public hospitals providing adult cardiac surgical services in Australia and New Zealand was carried out between December 2019 and January 2020. The aim was to investigate current practice with regard to selected contentious elements of anaesthetic and perfusion management during cardiopulmonary bypass; primarily relating to bypass circuit priming, blood conservation methods and point-of-care coagulation testing. There was a 100% response rate. The average number of adult public cardiopulmonary bypass cases per hospital was 508 (160-1400). For cardiopulmonary bypass cases, ten hospitals (34%) routinely used a cell saver and the remainder used a cell saver selectively. Residual blood remaining in the cardiopulmonary bypass circuit was processed using a cell saver routinely in four hospitals (14%) and selectively in 23 (79%). Acute normovolaemic haemodilution was rarely used. Retrograde autologous priming was used routinely in seven hospitals (24%) and selectively in 16 (55%). All hospitals had access to point-of-care coagulation testing. The majority of hospitals targeted an activated clotting time of 480 s (range 400-500 s) prior to commencing cardiopulmonar...Continue Reading

References

Oct 27, 2007·Journal of Cardiothoracic Surgery·Kelvin LauNeil Moat
Sep 18, 2013·Scandinavian Cardiovascular Journal : SCJ·Jakob GäbelAnders Jeppsson
Jul 25, 2015·The Annals of Thoracic Surgery·Joshua GoldbergUNKNOWN PERForm Registry and the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative
May 4, 2016·Acta Anaesthesiologica Scandinavica·J GäbelA Jeppsson
May 2, 2017·European Journal of Anaesthesiology·Sibylle A Kozek-LangeneckerKai Zacharowski
Oct 14, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Domenico PaganoChrista Boer
Nov 12, 2017·Journal of Cardiothoracic and Vascular Anesthesia·Michael I MeestersChrista Boer
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Aug 26, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Massimo MecoGiovanni Albano
Oct 6, 2019·British Journal of Anaesthesia·UNKNOWN Authors/Task Force MembersStaffan Svenmarker
Oct 22, 2019·JAMA : the Journal of the American Medical Association·Jeannie CallumUNKNOWN FIBRES Research Group

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Methods Mentioned

BETA
RAP
coronary artery bypass

Software Mentioned

INTEM

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