National Heart Center Perfusion Guidelines.

Area of Science:

• Cardiovascular Surgery
• Perfusion Technology
• Evidence-Based Medicine

Background:

• Cardiopulmonary bypass (CPB) is essential for complex cardiac surgeries but carries risks.
• Establishing national standards for perfusion best practices in Saudi Arabia is crucial for patient safety.

Purpose of the Study:

• To develop the first national standards and guidelines for best practice in perfusion for Saudi Arabian patients undergoing cardiothoracic surgery.
• To provide evidence-based recommendations for optimal patient care during CPB.

Main Methods:

• The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was utilized.
• A panel of 16 cardiovascular perfusion experts formulated clinical questions and reviewed literature from 2010-2024.
• Guideline recommendations were approved via a consensus process using the GRADEpro system.

Main Results:

• 16 conditional recommendations and 6 good practice statements were approved across 5 key domains.
• Strong recommendations include pre-bypass checklists and perioperative glycemic management.
• Key areas covered include guidelines, surgical techniques, heart-lung machine hardware, priming solutions, and monitoring.

Conclusions:

• These Saudi guidelines offer evidence-based recommendations to enhance patient care during cardiac surgery with CPB.
• The guidelines provide clear direction for clinicians to achieve optimal surgical outcomes.
• Future local research and regular updates are necessary to address evidence gaps.