A retrospective study on perfusion incidents and safety devices
A retrospective study on perfusion incidents and safety devices
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DOI：
10.1177/026765910001500108
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发表时间：
2000-01-01
期刊：
影响因子：
1.2
通讯作者：
Viessman, T
中科院分区：
文献类型：
--
作者：
Mejak, BL;Stammers, A;Viessman, T
尽管接受体外循环作为一种有效的方式，以促进心脏手术，病人的结果可能会受到负面影响的灌注事件的发生。我们进行了一项灌注调查，以确定与心肺转流（CPB）相关的安全技术和事件。一份80个问题的调查问卷邮寄给了美国所有1030个使用CPB的心脏外科中心的首席灌注师。调查的目的是审查两年期间（1996年7月至1998年7月）发生的做法和事件。552份（54%的应答率）调查被退回，其中包括797家医院（占所有心脏中心的79%）和653621例外科手术。在27种已识别的CPB安全器械中，使用率最高的是动脉管路过滤器（98.5%），最低的是动脉管路除泡器（3.4%）。在报告的病例中，每138例中发生一次CPB事件。最常见的事件是鱼精蛋白反应（1：783）、凝血问题（1：771）和加热器/冷却器故障（1.1809）。导致严重伤害或死亡的事件发生率为每1453例手术中有一例。尽管技术和安全设备为CPB创造了相对安全的环境，但随着凝血监测和事件报告的进一步改进，可能会降低事件发生率。
Despite the acceptance of extracorporeal circulation as an effective modality to facilitate cardiac surgery patient outcomes can be negatively influenced by the occurrence of perfusion incidents. A perfusion survey was conducted to identify safety techniques and incidents related to cardiopulmonary bypass (CPB).An 80-question survey was mailed to chief perfusionists of ail 1030 USA cardiac surgical centers using CPB. The survey was designed to examine practices and incidents that occurred during a 2-year period (July 1996 to July 1998). Five-hundred-and-fifty-two (54% response rate) surveys were returned, which accounted for 797 hospitals (79% of all cardiac centers) and 653 621 surgical procedures. Of the 27 identified CPB safety devices, the highest utilization was arterial line filters (98.5%) and the lowest arterial line bubble traps (3.4%). Of the reported cases, a CPB incident occurred once every 138 cases. The most common occurring incidents were protamine reactions(1:783), coagulation problems (1:771), and heater/cooler failures (1.1809). The rate of occurrence of an incident resulting in a serious injury or death was one for every 1453 procedures.Although techniques and safety devices create a relatively secure environment for CPB, lower incident rates may be achieved with further improvements in coagulation monitoring and incident reporting.