Document Detail

A 10-year review of pediatric perfusion practice in North America.
MedLine Citation:
PMID:  11958308     Owner:  NLM     Status:  MEDLINE    
In December 1999, 145 North American pediatric open-heart institutions were mailed an updated survey as a follow-up of two earlier surveys, 1989 and 1994. The survey consisted of 81 questions pertaining to demographics, equipment, techniques and patient monitoring. This survey, following a similar format of the two earlier surveys, provides a 10-year review encompassing both new and founded practices performed during the conduct of pediatric cardiopulmonary bypass. Responses were received from 83 hospitals, for a 57% response rate. Of the respondents, 72 were active pediatric open-heart centers, 67% performing both adult and pediatric cardiac surgery and 33% performing pediatric surgery exclusively. The mean number of pediatric cases performed in 1999 was 169, compared to 101 cases in 1989 and 145 cases in 1993. Of the 72 respondents, 51% were performing greater than 100 cases/year, whereas 3% of centers were performing under 25 cases/year. As the decade progressed, bubble oxygenators were completely replaced by their membrane counterpart. The use of ultrafiltration, reported first in the 1989 survey, has risen by over 30%. The use of colloids in the prime, specifically 25% albumin, has increased in use from 34% in 1989 to 85% in 1999. Rewarming gradients are used by 100% of respondents with a mean gradient of 9.4 degrees C between the patient and water bath. Myocardial protection has seen an increase of close to 20% in the use of blood cardioplegia. The use of safety devices is also on the rise with more centers using level detectors (79%), bubble detectors (88%) and arterial line filters (96%). Centers relying on the use of cardiac assist devices have increased by 25% since 1989. Results of this survey suggest a movement toward a higher volume of cases being performed at fewer centers. While some diversity is seen, movement toward greater homogeneity, first noted in the 1994 survey, continues in 1999.
Giovanni Cecere; Robert Groom; Richard Forest; Reed Quinn; Jeremy Morton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Perfusion     Volume:  17     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-04-17     Completed Date:  2003-07-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  83-9     Citation Subset:  IM    
Cardiac Surgery Department, Maine Medical Center, Portland 04102, USA.
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MeSH Terms
Cardiology Service, Hospital / statistics & numerical data,  trends*,  utilization
Cardiopulmonary Bypass / instrumentation,  methods,  trends
Child, Preschool
Data Collection
Disease Management
Filtration / methods,  utilization
Heart Defects, Congenital / therapy
Hypothermia, Induced / utilization
Infant, Newborn
North America
Oxygenators / trends,  utilization
Pediatrics / instrumentation,  methods*,  trends
Perfusion / instrumentation,  methods*,  trends
Protective Devices / utilization

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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