Predicting Adult Perfusion Practice Trends and the Adoption of Evidence-Based Practice

Abstract

In an effort to provide optimal patient care, perfusionists should rely on information provided by current research. Present statistics, however, document a substantial underuse of evidence-based clinical practice and therapies not only in perfusion, but throughout the entire medical field. This investigation applied a statistical method—binomial proportion analysis—to aid in uncovering the trends in perfusion practice from 2004 to 2011. Through the analysis of national adult perfusion practice surveys, the feasibility of using binomial proportion statistical analysis is assessed in its ability to track adult perfusion practice proportional differentials over time and evaluate the adoption and attitudes toward the compliance of evidence-based practice within the field of perfusion. Surveys conducted in 2004 and 2006 on adult perfusion practice in the United States—although not published—are compared with data obtained by a similar survey distributed in 2011 through an international perfusion network system and perfusion mailing system, Perflist and Perfmail. The increase of perfusionists who practice retrograde and antegrade autologous priming (R/A AP) seen from 2004 to 2006 (35–50%) was statistically significant (Zcalc = −2.30, p < .05) and from 2006 to 2011 (Zcalc = −5.23; p < .05). Although the increase in biocompatible circuit (BC) use by perfusionists from 2004–2006 (53–64%) was not statistically significant (Zcalc = −1.69, p < .05), the use of BCs did continue to increase (86%) significantly from 2006 to 2011 (Zcalc = −9.15, p < .05). Other trends were observed; however, statistical significance was variable. This investigation demonstrates that binomial proportion statistical analysis is an effective method of evaluating perfusion practice trends and adoptions based on increasing or decreasing perfusion population proportion compliance over time.

Ultrafiltration in cardiac surgery: Results of a systematic review and meta-analysis

“…According to a 2016 survey from the U.S., Canada, and non-North American centers, 79% of pediatric cardiac surgical respondents reported use of MUF, 23 but similar surveys of perfusion practices in adults are lacking. 24,25 MUF is performed after the patient has separated from CPB, thus providers may be reluctant to use the technique both due to the time it entails as well as the potential for relative hemodynamic instability during a phase when a patient’s clinical status can otherwise be quite dynamic. Unfortunately, this review was unable to characterize the association between MUF and organ injury as so few of the studies included AKI as one of their outcomes.…”