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Stanzel RD, Gehron J, Wolff M, Striegl N, Roth P, Boedeker RH, Scheibelhut C, Herrmann J, Welters I, Mayer E, Scheffler M. International survey on the perioperative management of pulmonary endarterectomy: the perfusion perspective. Perfusion 2017; 33:53-61. [DOI: 10.1177/0267659117724865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Pulmonary endarterectomy (PEA) is the most effective treatment available for chronic thromboembolic pulmonary hypertension (CTEPH). Patient selection, surgical technique and perioperative management have improved patient outcomes, which are traditionally linked to surgical and center experience. However, optimal perfusion care has not been well defined. The goal of the international survey was to better characterize the contemporary perfusion management of PEA and highlight similarities and controversies. Method: The combined caseload of 15 participating centers was 5,066 cases. Topics queried included materials and types of cardiopulmonary bypass (CPB) equipment, choice of prime, fluid management, deep hypothermia strategy, temperature management, treatment of acid-base abnormalities and intraoperative hematocrit as well as anticoagulation management for heparin-induced thrombocytopenia. Conclusion: Our assessment could provide a base for further advancement and may help design future studies to elucidate the impact of perfusion in this challenging field.
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Affiliation(s)
- Roger D.P. Stanzel
- Perfusion Services, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Johannes Gehron
- Cardiovascular Surgery, Dept. of Perfusion, University Hospital Giessen and Marburg, Giessen, Germany
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Matthias Wolff
- Anesthesiology, Intensive Care, Pain Therapy, University Hospital Giessen and Marburg, Giessen, Germany
| | | | - Peter Roth
- Department of Cardiovascular Surgery, University Hospital Giessen and Marburg, Giessen, Germany
| | - Rolf-Hasso Boedeker
- Institute for Medical Informatics, Justus-Liebig-University Giessen, Giessen, Germany
| | | | | | - Ingeborg Welters
- Institute of Ageing and Chronic Disease, Royal Liverpool University Hospital, Liverpool, UK
| | - Eckhard Mayer
- Kerckhoff Heart and Lung Center, Bad Nauheim, Germany
| | - Matthias Scheffler
- Department of Anesthesia, Perioperative Medicine and Pain Therapy, Dalhousie University, QEII Health Sciences Centre, Halifax, Canada
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