J Extra Corpor Technol 2025, 57, 82 – 88 Ó The Author( s), published by EDP Sciences, 2025 https:// doi. org / 10.1051 / ject / 2025007
Available online at: ject. edpsciences. org
ORIGINAL ARTICLE
Perfusion practices and safety standards in Pakistan: Insights from a preliminary nationwide survey
Salman Pervaiz Butt( DBA MBA MSc MPHYS ACCP FCCP CES-A) 1,*, Nabeel Razzaq( AACP MSc) 2, Bill Cook( CCP) 3, Babar Ali( MSc) 4, Hashim Saqib( BSc) 5, Aerfa Amir( Medical Student) 6, Yazan Aljabery( MD) 2, Salman Abdulaziz( MBBS, FRCP) 7, and Arshad Ghori( MD) 8
1 Manager Perfusion Services, Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, Abu Dhabi, United Arab Emirates 2 Clinical Perfusionist Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, Abu Dhabi, United Arab Emirates 3 Clinical Perfusionist, Perfusion Department, Glenfield Hospital, Leicester, LE3 9QP, UK 4 Department of Cardiac Perfusion Technology, Khyber Medical University, 25100 Peshawar, Pakistan 5 Bashir Institute of Health Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, 44000 Islamabad, Pakistan 6 Rahbar Medical and Dental College, Lahore, 54810, Pakistan 7 ECMO Task Force, Department of Health, PO BOX 5674, 20224 Abu Dhabi, United Arab Emirates 8 Anaesthesiology Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, Abu Dhabi, United Arab Emirates
Received 3 October 2024, Accepted 13 March 2025
Abstract – Introduction: Perfusion safety in cardiothoracic surgery is critical, particularly in Pakistan where variability in practice standards exists. This survey investigates the current perfusion practices among Pakistani perfusionists, focusing on the adherence to safety standards during cardiopulmonary bypass( CPB) procedures. Methods: The survey was conducted over two weeks to explore key areas of perfusion practice, including the use of bubble detectors, level detectors, arterial filters, and saturation monitoring during CPB procedures. Out of approximately 350 practicing perfusionists in Pakistan, 66 responded, resulting in a response rate of 18.9 %. The data was collected through an online platform, ensuring anonymity and voluntary participation. The survey included mainly Yes / No questions. To ensure reliability and validity, the questionnaire was reviewed by experts, pilot tested, and refined based on feedback, ensuring it was effective in gathering meaningful insights. Results: The survey results indicate a variable use of essential safety devices such as bubble and level detectors, arterial filters, and continuous venous saturation and cerebral saturation monitoring. While some perfusionists adhere to recommended safety protocols, gaps in the use of critical monitoring equipment were evident. Conclusion: The findings highlight the need for standardized perfusion practices in Pakistan to ensure safety and efficacy during CPB. Addressing the gaps in the use of safety and monitoring equipment could lead to improved patient outcomes. Further research is needed to explore the barriers to uniform safety standards and to develop strategies for enhancing perfusion safety across the country.
Key words: Perfusion safety, Cardiopulmonary bypass, Safety standards, Pakistan, Perfusion practices, Survey.
Introduction
Cardiopulmonary bypass( CPB) is a critical component of cardiac surgeries, playing a crucial role in the outcome of such procedures. In Pakistan, where variations in medical practice standards are significant, ensuring the safety and effectiveness of CPB is particularly challenging. Perfusionists, who operate the heart-lung machines during these surgeries, have a pivotal role in managing these systems and their adherence to safety standards critically impacts patient outcomes. This survey is designed to assess current practices among Pakistani perfusionists regarding the use of monitoring and safety equipment
* Corresponding author: buttsab9 @ hotmail. com during CPB procedures. It seeks to evaluate the extent to which essential safety and monitoring tools are employed, and to identify any discrepancies or commonalities in practice that could inform future improvements in the field. This initiative is part of a broader effort to standardize perfusion practices across the country to ensure high-quality and safe surgical outcomes.
Methodology
This survey was conducted to explore several key areas of perfusion practice, including the routine use of bubble detectors, level detectors, arterial filters, continuous inline venous saturation monitoring, and cerebral saturation monitoring
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