Perfusion Treatment Algorithm

Methods of Improving the Quality of Perfusion

Hunter B. Holcomb, Alfred H. Stammers, Chen Gao, Bernadette Nutter, Tina Ellis, Rebecca L. Ahlgren, Ryan G. Schmer, Lynette M Smith

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The pathophysiological consequence associated with cardiopulmonary bypass (CPB) has generated a movement away from this technology in the treatment of heart disease. The negative outcomes are multifactorial in origin and may be associated both with the conduct of CPB and the instrumentation of extracorporeal flow. The purpose of this study was twofold. First, to develop a bedside patient risk assessment to aid in the development of a perfusion care plan. Second, to identify the controllable variables used during CPB that contribute to overall morbidity. Controllable perfusion-related variables that were positively linked to improved patient outcomes were identified from randomized, peer-reviewed human studies. Such variables as hematocrit, mean arterial pressure, thermic perfusion, blood lactate, colloid osmotic pressure, pulsatile perfusion, acid base homeostasis, oxygenation, and coated circuitry were included. Patient risk assessment was developed using the Society of Thoracic Surgeon database, where 61 variables affecting postoperative morbidity were identified. These variables were used to develop a bedside tool, Mortality Assessment Perfusion Score (MAPS), to guide the perfusion patient care plan. The MAPS generates a specific value that may predict patient morbidity and mortality based on past mortalities. In conclusion, the improvement in patient outcome may be associated with both the change in conduct of CPB and the quantitative assessment of patient risk stratification and a patient treatment algorithm.

Original languageEnglish (US)
Pages (from-to)290-296
Number of pages7
JournalJournal of Extra-Corporeal Technology
Volume35
Issue number4
StatePublished - Dec 1 2003

Fingerprint

Perfusion
Cardiopulmonary Bypass
Mortality
Morbidity
Therapeutics
Pulsatile Flow
Osmotic Pressure
Colloids
Hematocrit
Heart Diseases
Lactic Acid
Patient Care
Arterial Pressure
Homeostasis
Thorax
Hot Temperature
Databases
Technology
Acids

Keywords

  • Outcomes
  • Patient care plan
  • Risk
  • Risk stratification

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Professions (miscellaneous)
  • Cardiology and Cardiovascular Medicine

Cite this

Holcomb, H. B., Stammers, A. H., Gao, C., Nutter, B., Ellis, T., Ahlgren, R. L., ... Smith, L. M. (2003). Perfusion Treatment Algorithm: Methods of Improving the Quality of Perfusion. Journal of Extra-Corporeal Technology, 35(4), 290-296.

Perfusion Treatment Algorithm : Methods of Improving the Quality of Perfusion. / Holcomb, Hunter B.; Stammers, Alfred H.; Gao, Chen; Nutter, Bernadette; Ellis, Tina; Ahlgren, Rebecca L.; Schmer, Ryan G.; Smith, Lynette M.

In: Journal of Extra-Corporeal Technology, Vol. 35, No. 4, 01.12.2003, p. 290-296.

Research output: Contribution to journalArticle

Holcomb, HB, Stammers, AH, Gao, C, Nutter, B, Ellis, T, Ahlgren, RL, Schmer, RG & Smith, LM 2003, 'Perfusion Treatment Algorithm: Methods of Improving the Quality of Perfusion', Journal of Extra-Corporeal Technology, vol. 35, no. 4, pp. 290-296.
Holcomb HB, Stammers AH, Gao C, Nutter B, Ellis T, Ahlgren RL et al. Perfusion Treatment Algorithm: Methods of Improving the Quality of Perfusion. Journal of Extra-Corporeal Technology. 2003 Dec 1;35(4):290-296.
Holcomb, Hunter B. ; Stammers, Alfred H. ; Gao, Chen ; Nutter, Bernadette ; Ellis, Tina ; Ahlgren, Rebecca L. ; Schmer, Ryan G. ; Smith, Lynette M. / Perfusion Treatment Algorithm : Methods of Improving the Quality of Perfusion. In: Journal of Extra-Corporeal Technology. 2003 ; Vol. 35, No. 4. pp. 290-296.
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