Recently I attended the 2017 Annual Meeting of The American Academy of Cardiovascular Perfusion. The AACP, as always, offered strong educational content and a great opportunity to meet up with friends and colleagues. While there, I had the pleasure of presenting co-authored research on “The Effectiveness of Acute Normovolemic Hemodilution and Autologous Prime on Intraoperative Blood Management during Cardiac Surgery.” The AACP honored our team, which includes our perfusion associates and their tireless dedication to clinical excellence and data collection, by selecting this work as the meeting’s Best Paper. I encourage you to read the abstract for additional detail, but here’s a summary of our findings, which highlight the value of thoughtful perfusion strategies that can reduce the need for costly transfusions and increase the likelihood of better clinical outcomes.
Ultrafiltration is thought to reduce morbidity and the risk of red blood cell transfusion, however very few studies have examined the relationship between ultrafiltration and the overall risk of intraoperative RBC transfusion. Using data from the SpecialtyCare Operative Procedural Registry (SCOPE™), our study looks at a population of nearly 98,000 adults undergoing cardiac surgery at 197 hospitals to evaluate the effects of ultrafiltration volume removed during CPB on the relative risk of receiving an intraoperative RBC transfusion. Recognizing the findings of our own previous work, we were especially interested in testing potential differences between male and female patients in the effects of ultrafiltration.
It is a fairly well-known fact in the cardiac community that women have higher morbidity and mortality associated with coronary artery bypass (CABG) procedures. The reasons traditionally given for this disparity include women’s relatively smaller vasculature, higher incidence of anemia, and smaller circulating blood volume. Early in 2016, we in the Medical Department were discussing this phenomenon and decided to design a study using the robust data from our SpecialtyCare Operative Procedural Registry to find something in the intraoperative space that might be leading to these very different post-operative outcomes for men and women. Our findings were somewhat surprising.
SpecialtyCare is determined to drive awareness of perfusion as both a vital medical service and a smart career choice. As part of this effort, we are proud to officially launch the Brown-Brukardt Perfusion Scholarship Program. Every year, SpecialtyCare will award perfusion education tuition to two students enrolled in CAAHEP-accredited programs. Jim Brown and Gary Brukardt—men with close ties to SpecialtyCare who helped evolve the practice of perfusion over the last three decades—exemplified integrity, leadership, and dedication to patient care. Our goal is to support students who share these qualities and demonstrate outstanding potential as cardiovascular perfusionists.
The source of nosocomial infections can be elusive. For investigators, infections stemming from slow-growing bacteria are particularly difficult to identify and combat when symptoms do not present for months, or sometimes even years, after exposure. Add to these challenges the severity of potentially deadly infections and a bacterial outbreak can have devastating consequences. Such is the case with nontuberculous mycobacteria (NTM).
Today, the need for continuous improvement is a given. How can we do more with less, but not sacrifice quality? Ultimately, how can we deliver greater value? That is the core idea of value-based payment models now being tested across the country and lies at the heart of the mandatory cardiac bundles recently proposed by the Centers for Medicare and Medicaid Services (CMS). Getting the highest quality from all components of a bundled service is paramount. One such component, cardiovascular perfusion, can have a significant impact on outcomes, recovery, and readmissions. But, how do you know that the perfusionists in your OR are capable of driving value and helping you achieve your quality goals?
At the 37th Annual Meeting of the American Academy of Cardiovascular Perfusion (AACP), we presented research that used goal-directed perfusion methodology to determine oxygenator performance during clinical cardiopulmonary bypass. The study evaluates three oxygenators currently in clinical use and reflects how information collected by perfusionists could be utilized to provide new information to bridge gaps in knowledge when an absence of quality data is encountered.