# Perfusion practices and safety standards in Pakistan: Insights from a preliminary nationwide survey

## TL;DR

A survey of perfusion practices in Pakistan reveals inconsistent use of safety equipment during heart surgeries, highlighting the need for standardized protocols to improve patient outcomes.

## Contribution

This study provides the first nationwide insight into perfusion safety practices in Pakistan, identifying critical gaps in adherence to safety standards.

## Key findings

- Essential safety devices like bubble detectors and arterial filters are inconsistently used during cardiopulmonary bypass procedures.
- There is a notable gap in the use of continuous venous and cerebral saturation monitoring among perfusionists.
- The survey underscores the need for standardized perfusion practices to enhance safety and patient outcomes in Pakistan.

## Abstract

Introduction: Perfusion safety in cardiothoracic surgery is critical, particularly in Pakistan where variability in practice standards exists. This survey investigates the current perfusion practices among Pakistani perfusionists, focusing on the adherence to safety standards during cardiopulmonary bypass (CPB) procedures. Methods: The survey was conducted over two weeks to explore key areas of perfusion practice, including the use of bubble detectors, level detectors, arterial filters, and saturation monitoring during CPB procedures. Out of approximately 350 practicing perfusionists in Pakistan, 66 responded, resulting in a response rate of 18.9%. The data was collected through an online platform, ensuring anonymity and voluntary participation. The survey included mainly Yes/No questions. To ensure reliability and validity, the questionnaire was reviewed by experts, pilot tested, and refined based on feedback, ensuring it was effective in gathering meaningful insights. Results: The survey results indicate a variable use of essential safety devices such as bubble and level detectors, arterial filters, and continuous venous saturation and cerebral saturation monitoring. While some perfusionists adhere to recommended safety protocols, gaps in the use of critical monitoring equipment were evident. Conclusion: The findings highlight the need for standardized perfusion practices in Pakistan to ensure safety and efficacy during CPB. Addressing the gaps in the use of safety and monitoring equipment could lead to improved patient outcomes. Further research is needed to explore the barriers to uniform safety standards and to develop strategies for enhancing perfusion safety across the country.