Document Type : Original Article
Department of Anesthesiology, Lung Diseases Research Center, School of Medicine, Mashhad University of Medical Science , Mashhad, Iran.
Department of Cardiac Surgery, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran Univesity of Medical Siences , Tehran, Iran.
Department of Perfusion Technology, Faculty of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Introduction: In addition to the well-known benefits of cardiopulmonary bypass (CPB), there are also certain possible risks, some of which are avoidable and some of which are accidental. In addition to CPB, potentially life-threatening consequences include human error and mechanical disruptions. The purpose of this study is to conduct a retrospective analysis of CPB accidents in Iranian cardiovascular surgery departments.
Methods: This study included 151 Iranian perfusionists who were evaluated using a questionnaire created by the researchers. The questionnaire recorded all participants' demographic information as well as their experiences with human errors (e.g., perfusionist fatigue and drowsiness; errors in CPB circuit arrangement; and so on) and mechanical disturbances (cooling-warming circuit, oxygenator failure, electrical disruption, and so on). SPSS Version 16 was used to analyze all of the data.
Result: 1) venous obstruction and improper venous return had the highest recurrence rate of 89.4%, 2) Removing the venous cannula and venting the venous path 86.8%, 3) 79.5% were unable to raise (ACT) more than 400. Most significant injuries were caused by clots or thrombi during CPB (2.6%), 2) failure of the oxygenator (2.6%). Most deaths were caused by an air embolism (5.29).
Conclusions: Although the occurrence of human errors and mechanical disturbances cannot be predicted, they can be mitigated by the sharing of accidents and mistakes.