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Goal-Directed Perfusion

Content Type: Protocols | Provider

Created: September 30, 2023
Contributors: Christa Kampert, MHA, CCP, LP • ERAS Cardiac Collaborative Network
Editor: Cheryl Crisafi, MSN, RN, CNL • Amanda Rea, DNP, CRNP, AGACNP-BC, CCRN, CMC, CSC, E-AEC • Gina McConnell, RN, BSN, CCRN • Shannon Crotwell, RN, BSN, CCRN • Alexander Gregory, MD, FRCPC

Summary

Goal-directed perfusion (GDP) in cardiac surgery is an individualized approach to the management of cardiopulmonary bypass (CPB) that aims to optimize tissue and organ perfusion while reducing complications associated with CPB. This strategy relies on continuous monitoring and adjustment of perfusion parameters using real-time physiologic data to better align perfusion delivery with each patient’s metabolic needs during surgery.

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AI Assistance Statement

This summary was developed with assistance from artificial intelligence and reviewed, edited, and approved by the listed editor(s). Reference: OpenAI (2025). ChatGPT (November version) [Large language model]. 
https://chat.openai.com

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References

  1. Ranucci M, Romitti F, Isgrò G, Cotza M, Brozzi S, Boncilli A, Ditta A. Oxygen delivery during cardiopulmonary bypass and acute renal failure after coronary operations. Ann Thorac Surg. 2005 Dec;80(6):2213-20.
  2. Magruder JT, Weiss SJ, DeAngelis KG, Haddle J, Desai ND, Szeto WY, Acker MA; Penn Perfusion Team Working Group. Correlating oxygen delivery on cardiopulmonary bypass with Society of Thoracic Surgeons outcomes following cardiac surgery. J Thorac Cardiovasc Surg 2020; 19:S0022-5223(20)33322-5
  3. Ranucci M, Johnson I, Willcox T, Baker RA, Boer C, Baumann A et al. Goal-directed perfusion to reduce acute kidney injury: A randomized trial. J Thorac Cardiovasc Surg 2018;156: 1918-27.
  4. Magruder JT, Crawford TC, Harness HL, Grimm JC, Suarez-Pierre A, Wierschke C, Biewer J, Hogue C, Whitman GR, Shah AS, Barodka V. A pilot goal-directed perfusion initiative is associated with less acute kidney injury after cardiac surgery. J Thorac Cardiovasc Surg. 2017 Jan;153(1):118-125.e1.
  5. Gao P, Liu J, Zhang P, Bai L, Jin Y, Li Y. Goal-directed perfusion for reducing acute kidney injury in cardiac surgery: A systematic review and meta- analysis. Perfusion 2022 Feb 6:2676591211073783.