Essential XIV

Cardiopulmonary bypass (CPB) stand-by procedures shall have adequate perfusionist preparedness.

PRACTICE GUIDELINES

  1. A surgical procedure should be deemed a CPB pump stand-by through consultation with the attending surgeon.
     
  2. One perfusionist should be assigned for each stand-by procedure.
     
  3. A heart-lung machine consisting of a sterile extracorporeal set-up and ancillary equipment should be readily available for the procedure.
     
    1. Ancillary equipment may include heater/cooler(s), anticoagulation monitoring device, autotransfusion system, intra-aortic balloon pump and/or ventricular assist devices.
     
  4. Appropriate and backup perfusion supplies should be readily available.
     
  5. Completion of a pre-bypass checklist and recording pre-bypass information on the perfusion record (refer to Essential I; a-c) should be done as if CPB would occur.
     
  6. All anticipated prescribed perfusion medications should be readily available.
     
  7. The target level of anticoagulation for off-pump coronary artery bypass (OPCAB) and other CPB stand-by procedures should be included as a written protocol.
     
  8. The perfusionist should monitor and record patient anticoagulation status and other relevant laboratory data on the procedure record at a frequency determined by institutional perfusion protocol.