Goal-directed perfusion in children undergoing heart surgery

Blood carries oxygen and nutrients around the body. It also removes waste products from tissues and organs. This process is called perfusion.

Cardiopulmonary bypass or a heart-lung machine is a machine that temporarily takes over the function of the heart and lungs during open-heart surgery. It ensures that blood circulates around the body so it can deliver oxygen and remove waste as needed.

Goal-directed perfusion (GDP) during cardiopulmonary bypass aims to balance the oxygen supply and demand of a patient while they are undergoing surgery. Optimising oxygen delivery is a key objective of GDP. This approach protects vital organs, reduces the risk of acute kidney injury, and decreases overall hospital stays.

Perfusion management is an important factor determining both short- and long-term outcomes in children undergoing heart surgery. However, its use in children:

• Is inconsistently defined
• Lacks a well-established evidence base
• Lacks consistent and well-described practice

Project aims

This project will lay the groundwork for a national programme of research on GDP in paediatric heart surgery by:

• Defining its core components
• Identifying key physiological markers and heart-lung machine parameters
• Creating a standardised data structure

What we hope to achieve

We hope to produce an evidence-based map of physiological markers and target ranges, corresponding machine parameters, associated outcomes and an evidence gap map for GDP in paediatric heart surgery.