Key result
A quick reference tool was developed to allow cardiac surgery centers to determine patient pump flows based on oxygen delivery requirements using only body surface area and hemoglobin levels.
Why the study?
Goal-directed perfusion based on BSA and oxygen delivery may be safer than BSA-matched flow alone, but tools were needed to determine acceptable blood flows without additional dedicated monitoring technology.
Can a quick reference chart based on BSA and hemoglobin allow perfusionists to determine safe minimum blood flow rates for goal-directed perfusion without dedicated DO2 monitoring equipment?
Can a quick reference chart based on BSA and hemoglobin allow perfusionists to determine safe minimum blood flow rates for goal-directed perfusion without dedicated DO2 monitoring equipment?
The proposed quick reference tool enables cardiac surgery centers to adopt goal-directed perfusion techniques without requiring instantaneous DO2 monitoring equipment.
Answers are grounded in this paper and cite their sources.
May aid individualized CPB perfusion planning; leaves open prospective outcome validation.
Traditionally, blood flow rates on cardiopulmonary bypass are based primarily on a formula that matches cardiac index to the patient’s body surface area (BSA). However, Ranucci and associates in the Goal-Directed Perfusion Trial (GIFT) trial have shown that coupling the BSA with delivery of oxygen (DO 2 ), known as goal-directed perfusion (GDP), may be a safer approach to determine appropriate blood flows. The objective of this study was to create a GDP reference tool that would allow perfusionists to quickly determine the lowest acceptable blood flow needed to provide a patient of any BSA with a satisfactory DO 2 without the need for additional dedicated technology. We approached this problem by deriving a formula for flow (L/min), based on BSA, oxygen content of the blood, and a minimum DO 2 of 280 mL·min −1 m −2 . A quick reference GDP chart was created based on the derived formula, requiring only the patient’s BSA and hemoglobin level to determine a safe minimum flow rate. The proposed tool allows any cardiac surgery center to adopt the GDP technique, even in the absence of instantaneous DO 2 monitoring equipment.
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Rance et al. (2019) studied Cardiac surgery requiring cardiopulmonary bypass. Goal-directed perfusion quick reference tool vs. Traditional cardiac index-based flow was evaluated. A quick reference tool was developed to allow cardiac surgery centers to determine patient pump flows based on oxygen delivery requirements using only body surface area and hemoglobin levels.
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