AMERICAN SOCIETY OF EXTRACORPOREAL TECHNOLOGY

The National Society of Perfusionists

About the Society
ICEBP Newsletter #6 September 2010
ICEBP Newsletter # 6
September 2010
Can't read this properly? Go to the online version
International Consortium for Evidence-Based Perfusion
This is the sixth Newsletter from the International Consortium for Evidence-Based Perfusion.

In this issue, we have two interesting publications that are reviewed for you; one evaluating the effect of published guidelines on change in clinical practice, the other updating the Consensus Statement on Minimal Criteria for Reporting the Systemic Inflammatory Response on CBP.
Furthermore, we will update you on the upcoming Best Practices / Perfusion Safety Meeting 2010 to be held in Toronto.
In this Newsletter:

- The Ferraris Blood Conservation Clinical Practice Guidelines – update
- Update on the Consensus Statement on Inflammatory Response on CBP
- Best Practices / Perfusion Safety Meetng 2010 in Toronto
The Ferraris Blood Conservation Clinical Practice Guidelines
After the publication of the STS/SCA Blood Transfusion and Conservation Guidelines1 in 2007, the ICEBP responded with a letter to the editor2, claiming the participation of perfusionists in the development process was forgotten. We can gladly say that by now, we have been invited to participate in the development of the revision of these guidelines and that this will soon lead to the publication of a new document. It promises to be an interesting piece of work with new evidence on several topics, that hopefully will change some of the ongoing clinical practice. An executive summary is now being reviewed by the ICEBP Steering Committee for endorsement.
A recent joint publication in JECT3 and Anesthesia and Analgesia4 however, shows that it is not so obvious for Guidelines to be read, let alone that they lead to a change in practice. In the article, the results of a survey among perfusionists and anesthesiologists are published, about current practice and the role of the previously published guidelines in changing these practices.
In the conclusive statement, it is stated that, although “78% of anesthesiologists and 67% of perfusionists reporting having read all, part, or a summary of the Guidelines, [...], only 20% of respondents reported that an institutional discussion had taken place as a result of the Guidelines, and only 14% of respondents reported that an institutional monitoring group had been formed.” Furtheron, “Twenty-six percent of respondents reported 1 or more practice changes in response to the Guidelines. The changes made were reported to be highly (9%) or somewhat (31%) effective in reducing overall transfusion rates. Only 4 of 38 Guideline recommendations were reported by <5% of respondents to have been changed in response to the Guidelines.”
This survey clearly points out the need for clinical practice guidelines to be clearly written, well-distributed, available for all stakeholders, and build in such manner that it can produce change in practice, or at least start a discussion on if, and how clinical practice should adapt to the guidelines.
The results of the survey will be presented in a dedicated session during the Best Practices/Safety in Perfusion Meeting in Toronto in October.
The ICEBP is proud to announce the presence of Dr. Ferraris who will give a talk during this session on gaining comment from the perfusion profession.
Consensus Statement on Inflammatory Response on CBP
Another joint publication, this time in The Heart Surgery Forum5, backed up by an editorial in JECT6, updates the “Consensus Statement: Defining Minimal Criteria for Reporting the Systemic Inflammatory Response to Cardiopulmonary Bypass”-publication from 2008, which was mentioned in one of our previous newsletters7.
The article mentions 3 distinct recommendations for the conduct of clinical trials focused on the systemic inflammatory response. They are as follows:
(1) Measure at least 1 inflammation marker, defined in broad terms
(2) Measure at least 1 clinical end point, drawn from a list of practical, yet clinically meaningful end points, suggested by the consensus panel; and,
(3) Report a core set of CPB and perfusion criteria that may be linked to outcomes
The authors not only provide a definition of the inflammatory response, but also deliver a list of causal markers of systemic inflammation, a list of clinical end points and markers of organ injury, as well as a mandatory description of CPB equipment and perfusion techniques used.
The editorial in JECT6 describes extensively the process of data entry on the PerfSORT website8. When submitting your study data to this website, a PERFSORT compliance statement is provided, which can be pasted into the manuscript you publish.
This process is based on the CONSORT (Consolidated Standards of Reporting Trials) statement9 that is widely adopted by medical journals to standardize and increase the quality of research study submissions.
The ICEBP endorses the PERFSORT initiative and stimulates you to submit your data.
Best Practices / Safety in Perfusion Meeting 2010
The venue will be Toronto, Ontario, Canada with the first two days of the conference hosted at the CAE/ Michener Centre for Advancement of Simulation Education (CASE), a unique private/public partnership between the CAE and Michener Institute of Applied Health Sciences Sciences that leverages over 60 years of best practices acquired in the aviation simulation industry with 50 years of dedicated experience in health care education.
The final program of the yearly meeting is now available online. Two highlights to sparkle your interest:
- As mentioned before, Dr Victor Ferraris will give a talk entitled: ’2010 Update to the Society of Thoracic Surgeons Blood Conservation Guidelines - Gaining Comment from the Perfusion Profession’.
- We are also extremely fortunate to have as our keynote speaker Dr. Amitai Ziv. Dr Ziv is a world renowned expert in the field of medical simulation. He is the Deputy Director of the Sheba Medical Center at Tel Hashomer, Israel responsible for Risk Management, Quality Assurance and Medical Education. He is also founder and Director of MSR - the Israel Center for Medical Simulation.
Dr Ziv will give a talk, entitled: ‘Simulation-Based Education in Healthcare: Impact on Patient Safety, Culture and Practice’. To demonstrate the importance of simulation-based education in healthcare and its impact on patient safety and outcomes.
The Organizing Committee is extremely proud about providing its delegates the unique opportunity to experience a dedicated high fidelity simulation environment with four concurrent simulation sessions. This opportunity, coupled with 10 didactic sessions, makes this an extraordinary meeting to be savored and not missed.
The ABCP has awarded 21.3 Category 1 CEUs for this meeting.
Acknowledgements
We would like to thank Medtronic Inc. for their contribution to this Newsletter in providing us translational support for the Members of the ICEBP Steering Committee.
We hope you have enjoyed this Newsletter and hope you look forward to our seventh edition!
The Communications Subcommittee
References
1. Ferraris VA, Ferraris SP, Saha SP, Hessel EA, Haan CK et al for The Society of Thoracic Surgeons Blood Conservation Guideline Task Force Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline
Ann Thor Surg 2007; 83: 27-86
2. Robert A. Baker, Timothy A. Dickinson, Kenneth G. Shann, Donald S. Likosky and Allison Bednarski Spiwak Perfusion: Part of the Perioperative Blood Transfusion and Blood Conservation Management Team Ann Thorac Surg 2008;85:359
3. Donald S. Likosky, Daniel C. FitzGerald, Robert C. Groom, Dwayne K. Jones, Robert A. Baker et al The Effect of the Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery Clinical Practice Guidelines of the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists upon Clinical Practices JECT 2010; 42: 114–121
4. Donald S. Likosky, Daniel C. FitzGerald, Robert C. Groom, Dwayne K. Jones, Robert A. Baker et al The Effect of the Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery Clinical Practice Guidelines of the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists upon Clinical Practices Anesth Analg111: 316-23 2010;
5. Clive Landis, John Murkin, David Stump, Robert Baker, Joseph Arrowsmith et al Consensus Statement: Minimal Criteria for Reporting the Systemic Inflammatory Response to Cardiopulmonary Bypass The Heart Surgery Forum 2010; 13: E116-23
6. Michael Poullis, Robert A. Baker, Donald S. Likosky, Filip De Somer, Ian Johnson, Marco Rannucci Perfusion Data in Scientific Journals: Perfusion Standards of Reporting Trials JECT 2010; 42: 101–102
7. ICEBP Newsletter #4, November 2009 (../../../sections/Newsletter/Newsletter-articles/article3.html)
8. www.perfsort.net
9. Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 1996; 276: 637–9
Send this newsletter to a friend! By clicking on this link, you can send this newsletter in its original form to one or more of your friends whom you think might be interested.
Subscribe to this newsletter! If you got this newsletter from a friend, you can subscribe to it by using this link.
ICEBP - Mission & Vision
The International Consortium for Evidence-Based Perfusion (ICEBP) is a partnership and collaboration between perfusion societies, medical societies, clinicians and industry to improve continuously the delivery of care and outcomes for our patients.
To achieve this mission, we will focus our energies in two principle areas:
Registry
• Create an international perfusion registry and facilitate its implementation
• Identify gaps between current and evidence-based clinical practice
Guidelines
• Review, comment, and/or endorse evidence-based guidelines concerning the practice of cardiopulmonary bypass
• Collaborate with medical societies in the development of guidelines concerning the practice of cardiopulmonary bypass
In order to succeed, the ICEBP will foster communication amongst its membership through a web portal, scientific conference, and internal and external publications.