J Extra Corpor Technol 2024 , 56 , 55 – 64 Ó The Author ( s ), published by EDP Sciences , 2024 https :// doi . org / 10.1051 / ject / 2024006
Available online at : ject . edpsciences . org
ORIGINAL ARTICLE
Perfusion Measures and Outcomes ( PERForm ) registry : First annual report
David C . Fitzgerald ( DHA , MPH , CCP ) 1 , Xiaoting Wu ( PhD ) 2 , Timothy A . Dickinson ( MS , CCP ) 3 , Donald Nieter ( MHSA , DVM , CCP-Emeritus ) 4 , Erin Harris ( MS ) 1 , Shelby Curtis ( MS ) 1 , Emily Mauntel ( MS ) 1 , Amanda Crosby ( MS , CCP ) 5 , Gaetano Paone ( MD , MHSA ) 6 , Joshua B . Goldberg ( MD ) 7 , Alphonse DeLucia III ( MD ) 8 , Kaushik Mandal ( MD , MS , MPH ) 9 , Patricia F . Theurer ( MSN ) 4 , Carol Ling ( MS ) 2 , Jeffrey Chores ( MS , CCP ) 10 , and Donald S . Likosky ( PhD ) 2 , 4 ,*
1 Medical University of South Carolina College of Health Professions , 151-A Rutledge Avenue , A321 , Charleston , SC 29425 , USA 2 Department of Cardiac Surgery , Michigan Medicine , University of Michigan , 1500 E Medical Center Dr ., 5144 Cardiovascular Center ,
Ann Arbor , MI 48109-5864 , USA 3 Division of Cardiovascular Surgery , Mayo Clinic , 200 First Street SW , Rochester , MN 55905 , USA 4 Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative , Arbor Lakes Building 3 # 3130 / 4251 Plymouth Road ,
Ann Arbor , MI 48105 , USA 5 Department of Perfusion Services , University of Tennessee Medical Center , 1924 Alcoa Hwy , Knoxville , TN 37920 , USA 6 Division of Cardiothoracic Surgery , Emory University School of Medicine , 550 Peachtree Street , NE Davis-Fischer Bldg , 4th Floor ,
Atlanta , GA 30308 , USA 7 Department of Cardiothoracic Surgery , Weill Cornell Medical Center / New York Presbyterian Hospital , 525 E 68th St M 404 , New York , NY 10065 , USA 8 Department of Cardiac Surgery , University of Michigan Health West , 2122 Health Dr . SW , Suite 133 , Wyoming , MI 49519 , USA 9 Cardiovascular Services , Detroit Medical Center Sinai Grace Hospital , 6001 West Outer Drive Suite POB 321 , Detroit , MI 48235 , USA 10 Cardiovascular Services , Ascension St . John Providence Health System , 16001 West Nine Mile Road , Southfield , MI 48075 , USA
Received 2 February 2024 , Accepted 14 March 2024
Abstract – Background : The Perfusion Measures and Outcomes ( PERForm ) registry was established in 2010 to advance cardiopulmonary bypass ( CPB ) practices and outcomes . The registry is maintained through the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative and is the official registry of the American Society of Extracorporeal Technology . Methods : This first annual PERForm registry report summarizes patient characteristics as well as CPB-related practice patterns in adult ( 18 years of age ) patients between 2019 and 2022 from 42 participating hospitals . Data from PERForm are probabilistically matched to institutional surgical registry data . Trends in myocardial protection , glucose , anticoagulation , temperature , anemia ( hematocrit ), and fluid management are summarized . Additionally , trends in equipment ( hardware / disposables ) utilization and employed patient safety practices are reported . Results : A total of 40,777 adult patients undergoing CPB were matched to institutional surgical registry data from 42 hospitals . Among these patients , 54.9 % underwent a CABG procedure , 71.6 % were male , and the median ( IQR ) age was 66.0 [ 58.0 , 73.0 ] years . Overall , 33.1 % of the CPB procedures utilized a roller pump for the arterial pump device , and a perfusion checklist was employed 99.6 % of the time . The use of conventional ultrafiltration decreased over the study period ( 2019 vs . 2022 ; 27.1 % vs . 24.9 %) while the median ( IQR ) last hematocrit on CPB has remained stable [ 27.0 ( 24.0 , 30.0 ) vs . 27.0 ( 24.0 , 30.0 )]. Pump sucker termination before protamine administration increased over the study period : ( 54.8 % vs . 75.9 %). Conclusion : Few robust clinical registries exist to collect data regarding the practice of CPB . Although data submitted to the PERForm registry demonstrate overall compliance with published perfusion evidence-based guidelines , noted opportunities to advance patient safety and outcomes remain .
Key words : CABG , Surgery – Aortic valve , Replacement – Cardioplegia , Cardiopulmonary bypass – ( CPB ).
* Corresponding author : likosky @ med . umich . edu
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