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Best Practice for Cardiopulmonary Bypass in the High-Risk Elderly Patient

Department of Clinical Perfusion, Level 2 Building 4, Green Lane Hospital, Green Lane West, Auckland 1006, New Zealand

Rachel van Uden, ECCP

Green Lane Hospital, Auckland, New Zealand

The management of cardiopulmonary bypass has evolved over the last 50 years resulting in a largely consistent approach to both adult and pediatric perfusion. Very little has been written or prospectively researched on the best practice for cardiopulmonary bypass in the high-risk elderly patient, despite the challenge this patient cohort presents compared to the general adult population and the rapidly increasing number of such patients undergoing cardiac surgery. We propose a framework for perfusion strategies for the high-risk elderly patient from our current understanding of cardiopulmonary bypass. It should stimulate discussion for a consensus on perfusion strategies for the elderly and encourage further research into perfusion variables as they relate to the outcome of patients of advanced age.

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