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. 2019 Sep;51(3):172-174.

A Quick Reference Tool for Goal-Directed Perfusion in Cardiac Surgery

Rithy Srey  1   1 , Geoffrey Rance  1 , Alexander D Shapeton  2 , Kay B Leissner  2 , Marco A Zenati  1   3
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A Quick Reference Tool for Goal-Directed Perfusion in Cardiac Surgery

Rithy Srey et al. J Extra Corpor Technol. 2019 Sep.

Abstract

Traditionally, blood flow rates on cardiopulmonary bypass are based primarily on a formula that matches cardiac index to the patient's body surface area (BSA). However, Ranucci and associates in the Goal-Directed Perfusion Trial (GIFT) trial have shown that coupling the BSA with delivery of oxygen (DO2), known as goal-directed perfusion (GDP), may be a safer approach to determine appropriate blood flows. The objective of this study was to create a GDP reference tool that would allow perfusionists to quickly determine the lowest acceptable blood flow needed to provide a patient of any BSA with a satisfactory DO2 without the need for additional dedicated technology. We approached this problem by deriving a formula for flow (L/min), based on BSA, oxygen content of the blood, and a minimum DO2 of 280 mL·min-1m-2. A quick reference GDP chart was created based on the derived formula, requiring only the patient's BSA and hemoglobin level to determine a safe minimum flow rate. The proposed tool allows any cardiac surgery center to adopt the GDP technique, even in the absence of instantaneous DO2 monitoring equipment.

Keywords: acute renal injury; cardiopulmonary bypass; oxygen delivery; perfusion.

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