Midwest Heart Surgery Institute
Perfusion Department
Protocols and Guidelines for the Practice of Perfusion

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Table of Contents (click on the section links for more details)

SECTION 1: Principles

Purpose

Medical Director Review

Essentials and Guidelines for the Practice of Perfusion Practice

SECTION 2: Equipment Selection & Circuit Preparation

General Principles of Aseptic Technique

Operations of the Sarns Heater/Cooler

Prime Constituents of the Extracorporeal Circuit

Sterility of the Extracorporeal Circuit

SECTION 3: Patient Management & Perfusion Technique

Initiation of Cardiopulmonary Bypass

Management of the Adult Patient on Cardiopulmonary Bypass

Termination of Cardiopulmonary Bypass

Guidelines for Pharmacological Support and Volume Replacement During CPB

SECTION 4: Cardioplegia Protocols

General Cardioplegia Protocols

Buckberg Blood Cardioplegia Protocols

Quest Blood Cardioplegia Protocol

Micro-Plegia

Myocardial Protection Solution (MPS)

Plegisol

SECTION 5: Pharmacological Protocols

Vasopressin (Anti-Diuretic Hormone)

R-Hirudin (Lepirudin, Refludan) Protocol

Argatroban (Novastan) Protocol

Angiomax (Bivalirudin) Protocol

SECTION 6: Special Procedures

Heartmate Vented Electric Left Ventricular Assist Device (LVAD) Implantation

Modified Ultrafiltration

Deep Hypothermic Circulatory Arrest Technique

Extracorporeal Membrane Ocygenation (ECMO)

AtriCure Atrial Ablation Procedures with Intra-Operative Pulmonary Vein Electrograms

Transporting Patients on ECMO

SECTION 7: Special Patient Considerations

Cold Agglutinins (Cyroproteins, Cold Hemagglution Disease)

Pregnant Patient

Sickle Cell Disease

Accidental Hypothermia

SECTION 8: Catastrophic Event Management

Massive Air Embolism

Oxygenator Change-Out

Arterial Filter Change-Out

Pump Head Separation

SECTION 9: Miscellaneous Departmental Guidelines

Cardiopulmonary Bypass Circuit Charges

Cardiopulmonary Bypass Circuit Surgical Credits

Protocol Version Key

Example