The Journal of ExtraCorporeal Technology Issue 55-1 | Page 19

B . Lohbusch et al .: J Extra Corpor Technol 2023 , 55 , 3 – 22 11 sampling bias , compound questioning , recall bias , and respondent misinterpretation of questions . Survey participation was limited to programs located in the Zone IV region of AmSECT , with a response rate of 34.7 %. A majority of center responses were received from Northeastern programs . Data collected from these centers may not be generalizable to centers outside of this region . Survey recruitment across additional zones would appreciably increase our understanding of adult perfusion practice . Additionally , the timing of the survey may have been influenced by the Covid-19 pandemic , as centers may have experienced changes in both cardiac surgical and ECMO procedural volume . Recruitment was also restricted to a database containing names and emails of chief perfusionists and managers . The lapse in time between database data collection and survey recruitment may have contributed to lower survey response rates . Many of the non-respondents were attributed

to invalid contact information , as several perfusion managers may have left their place of employment prior to the recruitment period . Lastly , this survey did not collect data on all aspects of clinical perfusion service . Examples include ultrafiltration , departmental quality improvement initiatives , or perfusion position vacancy rates .

Data availability

The Informed Consent and Survey Tool used in this study is available in the Appendix of this article .

Ethics

No animals or animal blood was used in this study . This study did not involve obtaining biospecimens or medical information from the participants , so institutional review board approval was not sought .

Authors contributions

The authors confirm contribution to the paper as follows : study conception and design : B . L ., B . M ., K . O ., R . C ., D . F .; data collection : J . W ., B . L .; analysis and interpretation of results : B . L ., B . M ., K . O ., R . C ., D . L ., D . F ., L . D .; draft manuscript preparation : B . L ., B . M ., K . O ., D . F ., D . L ., L . D . All authors reviewed the results and approved the final version of the manuscript .

Conclusion

Clinical practice surveys can be effective tools in identifying current perfusion staffing , techniques , and equipment utilization . Professional organizations may offer opportunities to promote the recruitment of member center participation .

Additional research is warranted to help explain the gaps that may exist between clinical practice guidelines and current perfusion practice . This survey identified several elements of perfusion practice that did not reach thresholds consistent with high-level clinical practice guidelines and professional standards . Longitudinal surveys may describe clinical trends over time and measure adherence to evidence-based and professional standards and guidelines . Benchmarking and trending analysis is necessary to identify areas of improvement , help predict changes in clinical resource management , and foster improved patient outcomes .

Acknowledgements . The authors would like to acknowledge the members of the International Consortium of Evidence-Based Perfusion ( ICEBP ) for their contribution to testing the survey tool prior to distribution .

Conflict of interest

Dr . Likosky reported ( 1 ) partial salary support to his institution from Blue Cross Blue Shield of Michigan in advancing quality in Michigan and ( 2 ) serving as a consultant to AmSECT .

Funding

Dr . Likosky received funding from the Agency for Healthcare Research and Quality as well as the National Institutes of Health . None of the other authors have other funding to share .

References

1 . American Heart Association . Heart procedures and surgeries . Available at : https :// www . heart . org / en / health-topics / heart-attack / treatment-of-a-heart-attack / cardiac-procedures-and-surgeries . Accessed March 30 , 2022 .

2 . Hessel EA 2nd . 2014 . A brief history of cardiopulmonary bypass . Semin Cardiothorac Vasc Anesth 18 ( 2 ), 87 – 100 .

3 . Likosky DS , Goldberg JB , DiScipio AW , et al . ( 2012 ) Variability in surgeons ’ perioperative practices may influence the incidence of low-output failure after coronary artery bypass grafting surgery . Circ Cardiovasc Qual Outcomes 5 ( 5 ), 638 – 644 .

4 . Shore-Lesserson L , Baker RA , Ferraris V , et al . ( 2018 ) STS / SCA / AmSECT clinical practice guidelines : anticoagulation during cardiopulmonary bypass . J Extra Corpor Technol 50 ( 1 ), 5 – 18 .

5 . Engelman R , Baker RA , Likosky DS , et al . ( 2015 ) The Society of Thoracic Surgeons , The Society of Cardiovascular Anesthesiologists , and The American Society of ExtraCorporeal Technology : Clinical practice guidelines for Cardiopulmonary Bypass-Temperature Management during cardiopulmonary bypass . Ann Thorac Surg 100 ( 2 ), 748 – 757 .

6 . Tibi P , McClure RS , Huang J , et al . ( 2021 ) STS / SCA / AmSECT / SABM update to the clinical practice guidelines on patient blood management . J Extra Corpor Technol 53 ( 2 ), 97 – 124 .

7 . American Society of Extracorporeal Technology ( AmSECT ). Standards and Guidelines for Perfusion Practice . Available at : https :// www . amsect . org / p / cm / ld / fid = 1617 . Accessed March 20 , 2022 .

8 . DioDato CP , Likosky DS , DeFoe GR , et al . ( 2008 ) Cardiopulmonary bypass recommendations in adults : the northern New England experience . J Extra Corpor Technol 40 ( 1 ), 16 – 20 .

9 . Kunst G , Milojevic M , Boer C , et al . ( 2019 ) 2019 EACTS / EACTA / EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery . Br J Anaesth 123 ( 6 ), 713 – 757 .

10 . Likosky DS , FitzGerald DC , Groom RC , et al . ( 2010 ) The effect of the perioperative blood transfusion and blood conservation in