International pediatric perfusion practice: 2011 survey results.

Area of Science:

• Pediatric Cardiac Surgery
• Cardiopulmonary Bypass Technology
• Surgical Innovation Adoption

Background:

• Numerous novel cardiopulmonary bypass (CPB) devices and innovative surgical methods are continually introduced.
• The extent of adoption of these advancements into routine clinical practice remains largely unquantified.

Purpose of the Study:

• To assess the current clinical practices and adoption rates of CPB technologies in pediatric congenital surgery centers worldwide.
• To identify variations in equipment and techniques across different geographic regions.

Main Methods:

• An electronic survey comprising 107 questions was distributed to 289 international pediatric congenital surgery centers.
• Responses from 146 (51%) centers were collected and analyzed, stratified by five distinct geographic regions.

Main Results:

• Most centers utilize hard shell venous reservoirs. Closed venous systems show higher adoption in Central/South America (50%) versus North America (3%) and Asia (10%).
• Modified ultrafiltration is employed by 71% of programs. Arterial bubble detection systems are universally used in North America and Oceana (100%) but less so in Central/South America (50%).
• Specific cardioplegia solutions exhibit regional preferences: "Del Nido" in North America (32%) and Custodial HTK in Europe (31%).

Conclusions:

• Significant geographic disparities exist in the adoption of CPB equipment and techniques within pediatric congenital surgery.
• These variations highlight opportunities for further research, standardization, and improvement in global pediatric cardiac surgical care.