Perfusion s Role in Blood Management Guidelines

Transcription

1 Perfusion s Role in Blood Management Guidelines Session 4 Standards and Guidelines in Blood Management 9:10-9:20am Jeffrey B. Riley Acknowledge: Mark Lucas and Keith Symolyk No disclosures AmSECT Q&O: Session 4 10/2/2014 1

2 *Perfusion s Role Be familiar with all peer-reviewed standards and guidelines applying to Perfusion and cardiac surgery Help Perfusionists incorporate relevant S&Gs into their institution s clinical practice guidelines AmSECT Mission is patient safety: Participate in writing Perfusion-related S&Gs with our colleagues Continue the national certification of PBM Technologists through the IBBM *And therefore AmSECT s role Perfusion s Role in Blood Management Guidelines CCP Role in PBM S&Gs 10/2/2014 2

3 Perfusion-Related S&Gs AABB Standards for PABCA with associated education and accreditation opportunities SABM Patient Blood Management Standards and associated education The Joint Commission PBM Performance Measurement Project with implementation guide and accreditation opportunities *Ferraris VA, Brown JR, Despotis GJ, et al update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg. 2011;91: [*Author Comment: Baker RA, et al. Ann Thorac Surg 2008;85:359] Baker RA, Bronson SL, Dickinson TA, et al. Report from AmSECT's International Consortium for Evidence-Based Perfusion: American Society of Extracorporeal Technology Standards and Guidelines for Perfusion Practice: J Extra Corpor Technol. 2013;45: Shann KG, Likosky DS, Murkin JM, Baker RA, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: a focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J Thor Cardiovasc Surg 2006;132: Perfusion s Role in Blood Management Guidelines Post and read these documents in your Perfusion care area Relevant S&Gs for CCPs 10/2/2014 3

4 Does your perfusion team have easy access to relevant PBM S&Gs? A. Yes B. No Footer Text 10/2/2014 4

5 Sample PBM S&Gs for CCPs Standard I: It is important to adopt a team approach to blood management with attainable goals to make blood cell preservation and conservation a viable practice. Recommendation I.1: Cardiac surgery anesthesia, surgery, nursing and perfusion specialties should continue to work to improve the team multi-modality approach to preserve blood cell mass and hematocrit. 1-4 Recommendation I.2: Perfusionists should work with Anesthesia should reduce the amount of crystalloid volume given and increase the patient s systemic vascular resistance as tolerated by afterload. 2,4,6-8 Recommendation I.3: CPB circuits should be safely condensed to an effective dilutional priming volume of 1,000 mls or less for adults to decrease the effects of hemodilution and hypoproteinemia. 7,9-11 Recommendation I.4: Autologous priming is an appropriate technique to minimize the effects of hemodilution from the ECC and should be considered for use with all CPB cases Perfusion s Role in Blood Management Guidelines Should PBM S&Gs be written for Perfusion Practice? CCP PBM S&Gs 10/2/2014 5

6 Should AmSECT write evidencebased PBM S&Gs for Perfusionists? A. Yes B. No Footer Text 10/2/2014 6

7 Summary: Our Role Increase familiarity and adoption of peer-reviewed standards and guidelines relevant to Perfusion practice and patients Motivate perfusionists to incorporate evidencebased guidelines in all local Perfusion clinical procedure guidelines Contribute to and have a voice in national multidisciplinary professional efforts to write standards It is a perfusionist and an AmSECT member s professional responsibility to read and respond to public postings of proposed S&Gs Perfusion s Role in Blood Management Guidelines Footer Text 10/2/2014 7

8 Should AmSECT design and offer a Patient Blood Management Specialist certification for Perfusionists? A. Yes B. No Footer Text 10/2/2014 8