The Journal of ExtraCorporeal Technology No 56-2 | Page 32

D . C . Fitzgerald et al .: J Extra Corpor Technol 2024 , 56 , 55 – 64 59

Table 2 . Disposables and monitoring equipment .

Continuous variables are expressed as median , [ IQR ], and categorical variables as count (%).

14.7 % of all procedures , respectively , ( Supplementary Table 3 ). Intraoperative viscoelastic testing was infrequently ( 25.6 %) used , although increased over time ( 20.1 % vs . 32.3 %). While a ratio dose of heparin given during surgery was the most common ( 63.5 %) method of calculating the protamine dose for anticoagulation reversal , its use diminished over time ( 68.9 % vs . 52.4 %) in part attributed to the increased use of heparin protamine titration ( 23.5 % vs . 37.0 %). The use of intraoperative insulin was reported in 80.8 % of all procedures ( Supplementary Table 4 ).

Cardiotomy suction was terminated following protamine administration in 70.2 % of procedures , a practice which increased from 54.8 % to 75.9 % of procedures over time , Table 5 . The overall rate of visible clot noted in the CPB circuit was 0.6 %. The majority ( 99.6 %) of procedures used a perfusion checklist . Transfer of care during the intraoperative period occurred in 10.5 % of cases . The rate of any of the ten intraoperative adverse events decreased from 0.7 % of cases to 0.5 %.

Discussion

This first annual PERForm registry report provides important benchmarking information for cardiac surgical operations utilizing CPB . Since its inception , the PERForm registry has developed a robust infrastructure that supports the onboarding of new hospitals , the matching of institutional perfusion and surgical harvest files , the dissemination of quarterly benchmarking reports , and quality improvement . Given its growth , partnership with AmSECT , range of academic and community hospitals , as well as penetration outside of the state of Michigan , the registry now is prepared to provide benchmarking data to the wider cardiac surgical community through an annual report . Future reports will focus on specific practices , patterns of care , and associated outcomes .

This report adds to the literature in three important ways . First , to our knowledge , this report is among the first to use clinically informed data to describe discrete CPB practices . Second , this report provides contemporaneous data reflecting adherence to evidence-based guidelines and professionally based standards and guidelines , Supplementary Table 5 . Third , this report is among the first to document the rate of intraoperative adverse events secondary to CPB procedures , including overall and annual trends in patient safety practices ( Table 5 ). The findings derived from this report benefit from the increasing penetration of the PERForm registry across the United States ( Supplementary Figure 1 ).

Clinical registry participation supports the assessment of care provided to adult cardiac surgical patients . Surveys have