2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery
Alexander Wahba, Gudrun Kunst, Filip De Somer, Henrik Agerup Kildahl, Benjamin Milne, Gunilla Kjellberg, Adrian Bauer, Friedhelm Beyersdorf, Hanne Berg Ravn, Gerdy Debeuckelaere, Gabor Erdoes, Renard Gerhardus Haumann, Tómas Guðbjartsson, Frank Merkle, Davide Pacini, Gianluca Paternoster, Francesco Onorati, Marco Ranucci, Nemanja Ristić, Marc Vives, Milan Milojevic, EACTS/EACTAIC/EBCP Scientific Document Group, Roberto Lorusso, Patrick Wouters, Prakash Punjab, R. Peter Alston, Örjan Friberg, Fabio Guarracino, Eugene A. Hessel, Miia Lehtinen, Sven Maier, Luca Di Marco, Bart Meyns, Juan Blanco-Morillo, Peter Fast Nielsen, Aleksandar Nikolić, Steffen Rex, Lars Saemann, Enrico Squiccimarro, Patrick W. Weerwind, Fabio Zanella
Abstract
The current document presents a revision of the 2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery, emerging from a collaborative effort among the EBCP, EACTAIC and EACTS to establish guidance for unified clinical practice guidelines (CPB) practice [1, 2]. The previous guidelines provided the first comprehensive European guidance based on evidence, promoting a message of excellence through collaboration within the cardiac surgical, perfusion and anaesthetic communities. With recent advances in research that unveiled new evidence related to CPB, an update to the 2019 guidelines was necessary. The revised guidelines reaffirm the foundational practices and incorporate new recommendations that align with the latest evidence-based medicine and contemporary European clinical practices. They expand the guideline's scope with additional sections addressing crucial topics such as temperature management and deep hypothermic circulatory arrest (DHCA). However, the necessity for further research persists, and this iteration of the guidelines emphasizes the ongoing need for scientific inquiry and trials in various CPB domains. Whereas recent international guidelines cover specific topics like patient blood management and perioperative medication, this document summarizes the evidence and directs readers to these comprehensive guidelines for further details [3, 4]. The task force acknowledges that there have been no significant updates related to CPB, and thus refers to existing materials. Due to length constraints, paediatric CPB has not been included in this edition. These guidelines concentrate on perfusion-related recommendations in addressing broad topics such as cardioplegia and minimally invasive surgery.