58 D . C . Fitzgerald et al .: J Extra Corpor Technol 2024 , 56 , 55 – 64
Figure
1 . Procedure types submitted to the PERForm registry between 2019 and 2022 . Categorical variables are expressed as count (%). Valve procedures include aortic , mitral , tricuspid , and pulmonic valves . Abbreviation : coronary artery bypass grafting ( CABG ).
Figure
2 . Trends in procedure types between 2019 and 2022 . Categorical variables are expressed as counts . Valve procedures include aortic , mitral , tricuspid , and pulmonic valves . Abbreviation : coronary artery bypass grafting ( CABG ).
Table 2 describes the disposables and monitoring equipment reported during the study period . The majority of CPB disposable components consisted of biocoated circuits ( all but cannula – 91.4 %) and centrifugal pumps ( 66.8 %), neither of which appreciably changed over time . More than half ( 57.1 %) of procedures were performed without a perfusion electronic medical record . Procedural use of arterial and venous gas trending increased over time ( 2019 vs . 2022 : 27.7 % vs . 39.1 %).
Cardioplegia was used in 96.3 % of operations , with intermittent delivery being used in 83.8 % of operations , Table 3 . The most common cardioplegia category was del Nido ( 40.1 %, followed by microplegia ( 19.5 %) and 4:1 ratio ( 17.0 %). Of note , data concerning the maintenance route was incomplete 26.8 % of the time . A terminal warm reperfusate ( i . e ., Hot Shot ) was used among 41.9 % of procedures , with “ blood only ” being the most common constituent .
Table 4 describes blood product utilization and fluid management . Approximately 36 % of all patients received an allogeneic red blood cell transfusion , with 80.0 % of those patients receiving blood within the postoperative period . The median ( IQR ) last pre-CPB hematocrit and last hematocrit on CPB were 36 ( 30 – 39 ) and 27 ( 24.0 – 30.3 ), respectively . The median ( IQR ) hematocrit at the time of the first transfusion was 21 % ( 19.0 – 23.0 ). Retrograde autologous prime was performed in 85.8 % of all procedures , although diminished in use over time ( 86.5 % vs . 83.4 %). The median ( IQR ) hematocrit at the time of the first transfusion was 21 % ( 19.0 – 23.0 ). Retrograde autologous prime was performed in 85.8 % of all procedures , although diminished in use over time ( 86.5 % vs . 83.4 %). The median ( IQR ) indexed net prime volume rose from 321.3 mL / min / m 2 ( 278.3 – 394.9 ) in 2019 to 349.2 mL / min / m 2 ( 288.4 – 427.9 ) in 2022 . Common prime constituents included heparin , balanced electrolyte solutions , sodium bicarbonate , and mannitol ( Supplementary Table 2 ).
Anticoagulation monitoring was performed using activated clotting time and heparin concentration devices in 97.8 % and