The Brazilian Society for Cardiovascular Surgery (SBCCV) and Brazilian Society for Extracorporeal Circulation (SBCEC) Standards and Guidelines for Perfusion Practice

Canêo, Luiz Fernando; Matte, Gregory S.; Groom, Robert C.; Neirotti, Rodolfo A.; Pêgo-Fernandes, Paulo Manuel; Mejía, Juan Alberto Cosquillo; Figueira, Fernando Augusto Marinho dos Santos; Filho, Élio Barreto de Carvalho; Costa, Fábio Murilo da; Chalegre, Sintya Tertuliano; Kalil, Renato A. K.; Almeida, Rui

doi:10.21470/1678-9741-2018-0347

Cited by 15 publications

(20 citation statements)

References 8 publications

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“…The following two documents have been recently published in Europe and Brazil, respectively: European Association for Cardio-Thoracic Surgery/European Association of Cardiothoracic Anesthesiology/European Board of Cardiovascular Perfusion guidelines on cardiopulmonary bypass in adult cardiac surgery 9 and the Brazilian Society for Cardiovascular Surgery/Brazilian Society for Extracorporeal Circulation Standards and Guidelines for Perfusion Practice. 10…”

Section: Introductionmentioning

confidence: 99%

“…The need for a separate document has been identified in the past by the AmSECT Pediatric and Congenital Perfusion Committee (PCPC), as well as other international perfusion organizations. 10,11 A subcommittee of AmSECT’s PCPC was assigned the task of developing the document entitled Standards and Guidelines for Pediatric and Congenital Perfusion Practice. 12 The title purposefully includes the terms pediatric and congenital to reflect the broad range in size and age of patients cared for by pediatric and congenital perfusionists.…”

Section: Introductionmentioning

confidence: 99%

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American Society of ExtraCorporeal Technology: Development of Standards and Guidelines for Pediatric and Congenital Perfusion Practice (2019)

Oldeen

Angona

Hodge

et al. 2020

World J Pediatr Congenit Heart Surg

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The development of standards and guidelines by professional societies offers clinicians guidance toward providing evidence-based care. The ultimate goals of standards and guidelines are to standardize care and improve patient safety and outcomes while also minimizing risk. The American Society of ExtraCorporeal Technology (AmSECT) currently offers perfusionists several clinical resources, primarily the Standards and Guidelines for Perfusion Practice; however, no document exists specific to pediatric perfusion. Historically, the development of a pediatric-specific document has been limited by available scientific evidence due to smaller patient populations, sample sizes, and variable techniques among congenital perfusionists. In the current setting of evolving clinical practices and increasingly complex cardiac operations, a subcommittee of pediatric perfusionists developed the Standards and Guidelines for Pediatric and Congenital Perfusion Practice. The development process included a comprehensive literature review for supporting evidence to justify new recommendations or updates to the existing AmSECT Adult Standards and Guidelines document. Multiple revisions incorporating feedback from the community led to a finalized document accepted by the AmSECT membership and made available electronically in May 2019. The Standards and Guidelines for Pediatric and Congenital Perfusion Practice is an essential tool for pediatric perfusionists and serves as the backbone for institutionally based protocols, promotes improved decision-making, and identifies opportunities for future research and collaboration with other disciplines. The purpose of this manuscript is to summarize the process of development, the content, and recommended utilization of AmSECT’s Standards and Guidelines for Pediatric and Congenital Perfusion Practice.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

American Society of ExtraCorporeal Technology: Development of Standards and Guidelines for Pediatric and Congenital Perfusion Practice (2019)

Oldeen

Angona

Hodge

et al. 2020

World J Pediatr Congenit Heart Surg

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“…One-way ANOVA-repeated measures were used to compare total pressure drop between venous reservoir levels (1500 mL, 2000 mL, and 2500 mL) and VAVD levels (0, −20, −40, −60, and Brazil has a long history of creating innovative products for cardiovascular surgery, including domestically produced heart-lung machines (HLMs), oxygenators, and other perfusion products. While Brazil maintains an environment of innovation, there are areas of clinical practice where outdated technologies are still clinically employed [17] . Some perfusionists and surgeons consider Brazilian non-servo-controlled HLMs unsafe for pediatric perfusion, especially when low flow is needed.…”

Section: Discussionmentioning

confidence: 99%

Impact of Vacuum-Assisted Venous Drainage on Forward Flow in Simulated Pediatric Cardiopulmonary Bypass Circuits Utilizing a Centrifugal Arterial Pump Head

Guimaraes¹,

Canêo²,

Matte³

et al. 2020

Braz J Cardiovasc Surg

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Objective: To analyze the impact of vacuum-assisted venous drainage (VAVD) on arterial pump flow in a simulated pediatric cardiopulmonary bypass circuit utilizing a centrifugal pump (CP) with an external arterial filter. Methods: The simulation circuit consisted of a Quadrox-I Pediatric oxygenator, a Rotaflow CP (Maquet Cardiopulmonary AG, Rastatt, Germany), and a custom pediatric tubing set primed with Lactated Ringer's solution and packed red blood cells. Venous line pressure, reservoir pressure, and arterial flow were measured with VAVD turned off to record baseline values. Four other conditions were tested with progressively higher vacuum pressures (-20,-40,-60, and-80 mmHg) applied to the baseline cardiotomy pressure. An arterial filter was placed into the circuit and arterial flow was measured with the purge line in both open and closed positions. These trials were repeated at set arterial flow rates of 1500, 2000, and 2500 mL/min. Results: The use of progressively higher vacuum caused a reduction in effective arterial flow from 1490±0.00 to 590±0.00, from 2020±0.01 to 1220±0.00, and from 2490±0.0 to 1830±0.01 mL/min. Effective forward flow decreased with increased levels of VAVD. Conclusion: The use of VAVD reduces arterial flow when a CP is used as the main arterial pump. The reduction in the forward arterial flow increases as the vacuum level increases. The loss of forward flow is further reduced when the arterial filter purge line is kept in the recommended open position. An independent flow probe is essential to monitor pump flow during cardiopulmonary bypass.

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“…Despite their limited resources, some centers continue to do a good work through leadership, patience, perseverance, dedication, adaptability and creativity that comes with working under adversity. In this context, a gradual implementation of standards and guidelines should avoid false urgency, provide the opportunity to learn and improve in addition to moderate the financial burden [1] .…”

Section: Inequalitymentioning

confidence: 99%

Making Progress in Perfusion Practices

Neirotti¹

2019

Braz J Cardiovasc Surg

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The Brazilian Society for Cardiovascular Surgery (SBCCV) and Brazilian Society for Extracorporeal Circulation (SBCEC) Standards and Guidelines for Perfusion Practice

Cited by 15 publications

References 8 publications

American Society of ExtraCorporeal Technology: Development of Standards and Guidelines for Pediatric and Congenital Perfusion Practice (2019)

American Society of ExtraCorporeal Technology: Development of Standards and Guidelines for Pediatric and Congenital Perfusion Practice (2019)

Impact of Vacuum-Assisted Venous Drainage on Forward Flow in Simulated Pediatric Cardiopulmonary Bypass Circuits Utilizing a Centrifugal Arterial Pump Head

Making Progress in Perfusion Practices

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