The Journal of ExtraCorporeal Technology No 56-2 | Page 33

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

Table 3 . Cardioplegia details .

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

traditionally been used to establish benchmarks for cardiovascular perfusion , including establishing trends in practice patterns [ 14 , 15 ], gaining consensus on essential clinical skills [ 16 ], and reporting adverse intraoperative incidents [ 17 ]. Unfortunately , this methodological approach is subject to bias , including recall bias ( when asking a respondent to recall the number of instances of a particular adverse outcome ) and survey bias ( survey respondents versus non-respondents may differ in known and unknown ways ). While the distribution of surveys provides the opportunity to amass large analytical datasets , investigators have reported variable survey response rates focused on both the cardiac surgical program ( 35 %– 100 %) [ 14 , 15 ] and perfusionist levels ( 52 %– 69 %) [ 17 – 19 ]. As such , one of the distinct contributions of the present report is the establishment of benchmarks that derive from clinical registry data whose denominators are validated against institutional STS-ACSD harvest files . The validation against the STS-ACSD is important to minimize bias in data submitted by PERForm participants .

This first annual report highlights several emerging trends in CPB practices . The most recent 2021 STS / SCA / AmSECT / SABM patient blood management guidelines identified several evidence-based perfusion interventions , including retrograde autologous priming ( RAP ), reduced CPB priming volume , and acute normovolemic hemodilution ( ANH ) [ 20 ]. While the present report documents that 85.8 % of procedures utilized RAP , its use decreased marginally over the study period ( 2019 vs . 2022 : 86.5 % vs . 83.4 %, p < 0.001 ). An observational study of participating PERForm hospitals in 2014 found RAP usage in the setting of isolated CABG was 71.4 %, suggesting a 21 % increase over the last 7 years [ 21 ]. The median ( IQR ) net prime volume indexed to a patient ’ s body surface area increased from 321.3 ml / m 2 ( 278.3 – 394.9 ) in 2019 to 349.2 ml / m 2 ( 288.4 %– 429.9 %) in 2022 , p < 0.001 . A previous PERForm analysis