Original Article

Perfusion practices and safety standards in Pakistan: Insights from a preliminary nationwide survey

¹ Manager Perfusion Services, Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, Abu Dhabi, United Arab Emirates
² Clinical Perfusionist Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, Abu Dhabi, United Arab Emirates
³ Clinical Perfusionist, Perfusion Department, Glenfield Hospital, Leicester, LE3 9QP, UK
⁴ Department of Cardiac Perfusion Technology, Khyber Medical University, 25100 Peshawar, Pakistan
⁵ Bashir Institute of Health Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, 44000 Islamabad, Pakistan
⁶ Rahbar Medical and Dental College, Lahore, 54810, Pakistan
⁷ ECMO Task Force, Department of Health, PO BOX 5674, 20224 Abu Dhabi, United Arab Emirates
⁸ Anaesthesiology Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, Abu Dhabi, United Arab Emirates

^* Corresponding author: buttsab9@hotmail.com

Received: 3 October 2024
Accepted: 13 March 2025

Abstract

Introduction: Perfusion safety in cardiothoracic surgery is critical, particularly in Pakistan where variability in practice standards exists. This survey investigates the current perfusion practices among Pakistani perfusionists, focusing on the adherence to safety standards during cardiopulmonary bypass (CPB) procedures. Methods: The survey was conducted over two weeks to explore key areas of perfusion practice, including the use of bubble detectors, level detectors, arterial filters, and saturation monitoring during CPB procedures. Out of approximately 350 practicing perfusionists in Pakistan, 66 responded, resulting in a response rate of 18.9%. The data was collected through an online platform, ensuring anonymity and voluntary participation. The survey included mainly Yes/No questions. To ensure reliability and validity, the questionnaire was reviewed by experts, pilot tested, and refined based on feedback, ensuring it was effective in gathering meaningful insights. Results: The survey results indicate a variable use of essential safety devices such as bubble and level detectors, arterial filters, and continuous venous saturation and cerebral saturation monitoring. While some perfusionists adhere to recommended safety protocols, gaps in the use of critical monitoring equipment were evident. Conclusion: The findings highlight the need for standardized perfusion practices in Pakistan to ensure safety and efficacy during CPB. Addressing the gaps in the use of safety and monitoring equipment could lead to improved patient outcomes. Further research is needed to explore the barriers to uniform safety standards and to develop strategies for enhancing perfusion safety across the country.