Original Article

Ten Common Perfusion Problems: Prevention and Treatment Protocols

¹ Oakland University, Perfusion Technology Program, Rochester, MI
² The Department of Surgery, School of Medicine, The University of Colorado Health Sciences Center, Denver, CO
^* PSICOR, Inc., San Diego, CA

^* Direct communications to: Ramona K. Schabel, 24484 Conifer, Farmington Hills, MI 48018

Abstract

(J. Extra-Corpor. Technol. 19[3] p. 392-398 Fall 1987, 30 ref.) Research has been done regarding the unfortunate consequences of cardiopulmonary bypass (CPB) problems, but written recommendations for preventing these problems have not been addressed. There are few, if any, commonly accepted protocols (which may decrease morbidity and/or mortality) to deal with specific perfusion accidents. We studied reports dealing with the incidence and nature of perfusion complications and found the most common perfusion problems included: protamine reaction, hypoperfusion, oxygenator failure, blood clotting within the extracorporeal circuit, line separation, gross contamination, transfusion errors, drug errors, gas embolism, and electrical failure. The purpose of this paper is to identify the perfusion problems that are “most likely” to occur, to recommend preventive measures, and to give examples of emergency protocols for treatment of these events. It is felt that the risk of perfusion accidents can be decreased through the use and practice of written prevention and treatment protocols and we recommend that perfusionists, surgeons, and anesthesiologists together do a failure analysis of their own systems and develop prevention and treatment protocols designed for their own needs.