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International Pediatric Perfusion Practice: 2016 Survey Results.

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Pediatric cardiac surgery centers show wide variations in cardiopulmonary bypass practices globally. While safety device use increased, regional differences persist in perfusion techniques and equipment.

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Pediatric Critical Care

Background:

  • New cardiopulmonary bypass (CPB) device techniques are frequently published.
  • The clinical adoption rates of these novel CPB techniques remain largely unknown.
  • Periodic surveys since 1989 have tracked practice patterns in pediatric cardiac centers.

Purpose of the Study:

  • To assess current pediatric cardiopulmonary bypass practices worldwide.
  • To identify regional variations in CPB techniques and equipment utilization.
  • To evaluate the adoption of emerging safety devices and electronic record-keeping.

Main Methods:

  • A 186-question online survey on perfusion practices was distributed in December 2016.
  • Responses were collected from 93 North American (NA) and 67 non-NA (NNA) pediatric cardiac surgery centers.
  • Data represented over 47,000 annual pediatric procedures (<18 years).

Main Results:

  • Significant practice variations were observed across geographic regions.
  • The most common pediatric CPB circuit included a hard-shell venous reservoir, roller pump, and membrane oxygenator.
  • Increased utilization of safety devices was noted; 50% of NA centers used electronic perfusion records versus 31% of NNA centers.
  • Regional differences in cardioplegia delivery and modified ultrafiltration (79% utilization) were evident.

Conclusions:

  • Substantial variation in pediatric CPB practices persists globally.
  • Increased adoption of safety devices is a positive trend.
  • Future surveys are essential to monitor the integration of new perfusion guidelines into clinical practice.