Issue |
J Extra Corpor Technol
Volume 42, Number 3, September 2010
|
|
---|---|---|
Page(s) | 191 - 198 | |
DOI | https://doi.org/10.1051/ject/201042191 | |
Published online | 15 September 2010 |
Abstract
Improving Cardiopulmonary Bypass: Does Continuous Blood Gas Monitoring Have a Role to Play?
* Ashford Hospital, Ashford, South Australia, Australia
† Flinders Medical Centre, Bedford Park, South Australia, Australia
‡ Flinders University, Bedford Park, South Australia, Australia
Address correspondence to: Robert A. Baker, PhD, Dip Perf, CCP(Aust), Cardiac Surgery Research and Perfusion, Flinders Medical Centre and Flinders University, 1 Flinders Drive, Bedford Park, South Australia 5042. E-mail: Rob.Baker@flinders.edu.au
Received:
8
September
2009
Accepted:
25
April
2010
The CDI™500 (Terumo Cardiovascular Systems, Ann Arbor, MI) is an in-line blood gas monitoring device that has been used in clinical practice for over a decade. Few randomized studies have evaluated the value of this device with respect to improved perfusion management. We routinely use automated continuous quality indicator programs to assess perfusion management. The aim of this study is to investigate in a prospective randomized trial the role of in-line blood gas monitoring in the improvement of blood gas management during cardiopulmonary bypass (CPB) utilizing continuous quality indicators. Patients were randomized into two groups (Control, CDI). Patients in the Control group received our standard CPB blood gas management, with intermittent blood gas results. Continuous blood gas measurements from the CDI™500 were recorded at 20-second intervals, with the perfusionist blinded to these measurements. Patients in the CDI group received standard CPB blood gas management, in addition to continuous blood gas measurements visible on the CDI™500, the alarm system activated, and the data recorded. Perfusion management for all cases was guided by institutional protocols. One hundred patients (50 in each group) were included in the study. No significant difference existed between the groups on demographic, surgical, or clinical outcomes. Blood gas levels of patients in the CDI group were able to be maintained in accordance to protocol a greater percentage of the time, e.g., pCO2 management was 2% versus 20% (p = .008); this was most notable for differences between the Control and the CDI group for pCO2 > 45 mmHg (p = .003). Practice variation determined via statistical control charts improved for both pH and pCO2, represented by a decrease in the variation associated with practice. Continuous blood gas monitoring with the CDI™500 results in significantly improved blood gas management as determined by adherence to institutional protocols.
Key words: cardiopulmonary bypass / perfusion / physiology
Presented at the Perfusion Downunder, Hayman Island, Australia, August 9–12, 2007; American Society of ExtraCorporeal Technology Best Practices in Perfusion Meeting, Montreal, Canada, October 4–6, 2007; 24th Annual Scientific Meeting, Australian and New Zealand College of Perfusionists, Melbourne, Australia, November 9–10, 2007; Perfusion Safety Meeting, American Society of ExtraCorporeal Technology, Puerto Vallarta, Mexico, June 18–21, 2008.
© 2010 AMSECT
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.