American Society of ExtraCorporeal Technology (AmSECT)
Pediatric and Congenital Perfusion Practice
Ce document comprend 22 recommandations et 109 références.
Contenu en anglais
Synthèse
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.
Messages clés
Institutions must develop and implement an annual operating procedure (protocol) for each standard.
A read-verify checklist is mandated for each cardiopulmonary bypass procedure and must be kept in the permanent medical record.
Continuous monitoring of parameters like arterial blood pressure, blood flow, venous and arterial oxygen saturation, and cerebral oximetry is required.
The 'n+1' staffing model shall be utilized at all times to ensure adequate staffing and patient safety.
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).
Nouveautés de cette 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.
Recommandations
Development of Institutionally-based Protocols
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.
Patients concernés: Pediatric and congenital patientsSituation: Cardiopulmonary bypass
Qualification, Competency and Support Staff
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.
Patients concernés: Pediatric and congenital patientsSituation: Cardiopulmonary bypass
Checklist
The perfusionist shall use a checklist for each cardiopulmonary bypass procedure.
Patients concernés: Pediatric and congenital patientsSituation: Cardiopulmonary bypass
Monitoring
Patient arterial blood pressure shall be monitored continuously during cardiopulmonary bypass procedures.
Patients concernés: Pediatric and congenital patientsSituation: Cardiopulmonary bypass
Staffing and On-call
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.
Patients concernés: Pediatric and congenital patientsSituation: Cardiopulmonary bypass
Crisis Management
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.
Patients concernés: Pediatric and congenital patientsSituation: Cardiopulmonary bypass
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