Goal Directed Perfusion: Genuinely Beneficial or Smoke and Mirrors? By Gary Grist RN CCP Emeritus
History of Goal Directed Therapy. Goal Directed Perfusion (GDP) is a concept inspired by Goal Directed Therapy (GDT). GDT was first described in 2001 by Rivers (1). The technique uses rigorous monitoring and intensive management of hemodynamics in high-risk perioperative… Read More
UTAH PROTOCOL by Thomas N. Muziani PA-C, CP June 30, 2005- revised December 23, 2018
This protocol’s premise is based upon a microplegia philosophy and application. Its clinical efficacy reflects 50 years clinical cardiac experience of-what will work and what does not. The basic postulation of the UTAH PROTOCOL (UP) on first review is counterintuitive… Read More
The PRONTO Procedure: A New Safety Standard For Oxygenator Change Out by Gary Grist RN CCP Emeritus
I first learned of the PRONTO procedure when I heard Robert Groom*, the Director Of Cardiovascular Perfusion, Maine Medical Center in Portland give a talk about it many years ago. PRONTO stands for Parallel Replacement of an Oxygenator that is… Read More
CPB FMEA #3: Heat exchanger leak in the oxygenator or cardioplegia heat exchanger.
This week’s FEMA is prompted by the recent chatter on the list servers about cleaning heater/coolers (H/C). The discussion centered on two aspects: 1) how to clean the water reservoir to kill microbial contamination without damaging the equipment and 2)… Read More
What Are The Native Reservoir And The Ready Reservoir?
Yes, it is possible to to ‘dry out’ a patient during cardiopulmonary bypass (CPB). The article (referenced below) is about pediatric patients, but I believe there is an adult correlation as well. What I learned is that patients coming off… Read More
Should Perfusionists Use a Transfusion Trigger on Cardiopulmonary Bypass?
I recently attended both the New Advances in Blood Management (NABM) and the Society for the Advancement of Blood Management (SABM) in Kansas City in 2009. At both meetings the consensus was that a low hematocrit is bad and a… Read More
How Ultrafiltration And MUF During Cardiopulmonary Bypass Really Work!
The mechanical separation of capillaries by edema decreases perfused capillary density which disrupts the oxygen pressure field. This can impact most of the soft tissues and organ systems in several ways and is frequently associated with organ failure. For… Read More