Perfusion. 2025 Oct 30:2676591251393364. doi: 10.1177/02676591251393364. Online ahead of print.
ABSTRACT
IntroductionCardiopulmonary bypass (CPB) plays a central role in pediatric cardiac surgery, yet standardized quality indicators (QIs) specific to pediatric practice remain underutilized across institutions.MethodsA comprehensive review of literature from 2010 to 2025 was conducted using PubMed, Embase, and the Cochrane Library. Eligible studies included randomized trials, observational research, and meta-analyses.ResultsDO2i > 340 mL/min/m2 in neonates and >400 mL/min/m2 in infants was associated with a lower risk of acute kidney injury (AKI). Lactate >3 mmol/L predicted major morbidity, while MAP >40-45 mmHg correlated with adequate perfusion. Maintaining Hct ≥25% and a fluid balance within ±5% of baseline also supported improved postoperative outcomes. The integration of real-time multimodal monitoring, including NIRS and venous oxygen metrics, enhances individualized perfusion management.ConclusionAdopting and standardizing QIs in pediatric CPB supports early detection of inadequate perfusion and enhances surgical safety. A structured, multimodal QI framework can facilitate institutional benchmarking, improve patient outcomes, and guide future innovation in pediatric perfusion practices.
PMID:41167199 | DOI:10.1177/02676591251393364
