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American Society of Extracorporeal TechnologyPerfusion2025advanced

Pediatric and Congenital Perfusion Practice

Published by American Society of ExtraCorporeal Technology (AmSECT)

22Recommendations

109References

Summary

AI-generated

The document provides an updated framework for safe and effective extracorporeal support care for pediatric and congenital patients, updated in 2024 to include new crisis management standards and modifications for better interpretation.

pediatric perfusioncongenital perfusionAmSECTextracorporeal circulationguidelinesn+1 staffingcrisis managementblood pressure monitoring

Key Takeaways

1
Institutions must develop and implement an annual operating procedure (protocol) for each standard.
2
A read-verify checklist is mandated for each cardiopulmonary bypass procedure and must be kept in the permanent medical record.
3
Continuous monitoring of parameters like arterial blood pressure, blood flow, venous and arterial oxygen saturation, and cerebral oximetry is required.
4
The 'n+1' staffing model shall be utilized at all times to ensure adequate staffing and patient safety.
5
A crisis management plan must be implemented for unforeseen circumstances, and duty hours must allow for adequate rest (minimum 8 hours rest per 16-hour shift).

What's New in This Version

The 2024 update includes modifications to existing standards (and their respective guidelines) to enhance their interpretation and use, as well as updating references. In addition, the update includes a new standard that focuses on crisis management.

Key Recommendations

Development of Institutionally-based Protocols

Standard 1.1
As a mechanism for applying each standard to clinical practice, an institution or service provider shall develop and implement an operating procedure (protocol) for each of the standards.
StandardProtocol Development

Qualification, Competency and Support Staff

Standard 2.1
A perfusionist, who is board certified by the American Board of Cardiovascular Perfusion or who demonstrates equivalent qualifications and competency, shall conduct cardiopulmonary bypass procedures.
StandardStaffing

Checklist

Standard 5.1
The perfusionist shall use a checklist for each cardiopulmonary bypass procedure.
StandardClinical Practice

Monitoring

Standard 7.1
Patient arterial blood pressure shall be monitored continuously during cardiopulmonary bypass procedures.
StandardMonitoring

Staffing and On-call

Standard 18.1
At minimum, the “n+1” staffing model shall be utilized at all times, where “n” equals the number of operating/procedure rooms in use at any given time at a single site.
StandardAdministrative/Staffing

Crisis Management

Standard 22.1
The perfusionist shall participate in a collaborative effort to implement an actionable crisis management plan for unforeseen circumstances that may prohibit the ability to perform standard duties.
StandardAdministrative

Scope & Objectives

Clinical Topic

Pediatric and Congenital Perfusion

Objectives

To provide perfusionists with a framework to guide safe and effective extracorporeal support care to pediatric and congenital patients.

Target Patient Population

Pediatric and congenital patients receiving extracorporeal support

Target Providers

PerfusionistsSurgeonsAnesthesiologistsNursesTechnicians

Patient Criteria & Setting

Therapeutic Area

Cardiovascular

Guideline Scope

Clinical Practice GuidelinesStandards of Care

Care Settings

Operating RoomHospital

Special Populations

PediatricCongenitalNeonatesInfants

Safety & Contraindications

Contraindications

Assisted venous return

Monitoring Guidance

Requires continuous monitoring of arterial blood pressure, line pressure, arterial blood flow, gas exchange, and temperature (patient and device).

Guideline Features

Dosing informationFlowcharts includedMultidisciplinary

Learning Context

Difficulty

advanced

Exam Relevance

American Board of Cardiovascular Perfusion (ABCP) certification

Learning Paths

Pediatric PerfusionCongenital Cardiac SurgeryCardiopulmonary BypassExtracorporeal SupportCrisis ManagementPerfusion Standards