Cardiopulmonary bypass for adult patients: a survey of equipment and techniques.
OBJECTIVE
The techniques and equipment used for cardiopulmonary bypass for adult cardiac surgery vary among institutions and may change over time. This study sought to document the changing patterns of practice.


METHODS
Voluntary survey of meeting participants.


METHODS
13th Annual San Diego Cardiothoracic Surgery Symposium (February 1993).


METHODS
There were 331 responses from perfusionists (79.5%), cardiac surgeons (11.2%), and anesthesiologists (6.3%). The majority of these participants were from institutions where more than 1,000 cardiac operations were performed annually.


RESULTS
It was found that 91.5% of the respondents used membrane oxygenators currently, compared with 5% in 1982 (as reported in a previous survey). Over 80% of the institutions surveyed used some type of perioperative cell-salvaging technique. Arterial line filters were used by 92% of the respondents compared with 64% in 1982. Also, 80% of the respondents were aware of the availability of leukocyte-depleting filters.


CONCLUSIONS
The probable reasons for the increased utilization of membrane oxygenators and arterial line filters include less damage to the formed elements of blood, fewer gaseous microemboli, and better control of carbon dioxide elimination and oxygenation. The authors anticipate that future surveys will document increased use of leukocyte-depleting filters because of the literature implicating neutrophils as mediators of tissue destruction in various disease processes, including myocardial reperfusion injury.
Silvay
G
G
Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY 10029, USA.
Ammar
T
T
Reich
D L
DL
Vela-Cantos
F
F
Joffe
D
D
Ergin
A M
AM
D000328:Adult; D000776:Anesthesiology; D001804:Blood Transfusion, Autologous; D002245:Carbon Dioxide / Q000097:blood; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods; D004618:Embolism, Air / Q000517:prevention & control; D017707:Erythrocyte Transfusion; D005374:Filtration / Q000295:instrumentation; D005544:Forecasting; D006801:Humans; D007430:Intraoperative Care; D007937:Leukapheresis / Q000295:instrumentation; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D009504:Neutrophils; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D010107:Oxygenators, Membrane; D010477:Perfusion; D010956:Plasmapheresis; D017713:Platelet Transfusion; D010818:Practice Patterns, Physicians'
D002245:Carbon Dioxide; D010100:Oxygen