Abstract：
OBJECTIVE: To describe perfusionist perspectives regarding waste anesthetic gas (WAG) management during cardiopulmonary bypass (CPB) and compare results to existing American Society of Extracorporeal Technology (AmSECT) guidelines and the 2016 National Institute of Occupational Safety and Health Survey of healthcare workers and anesthesia care providers.
METHODS: We developed a questionnaire with 26 questions covering institutional demographics, use of anesthetic gases, scavenging systems, and air monitoring practices.
METHODS: Web-based survey.
METHODS: Self-identified board-eligible perfusionist members of AmSECT, the American Academy of Cardiovascular Perfusion, and the Maryland and Wisconsin State Perfusion Societies in 2022.
METHODS: None.
RESULTS: Of the 4,303 providers sent the survey, 365 (8.5%) participated. Although 92% of the respondents (335/364) routinely administered inhaled anesthetics via the oxygenator, only 73.2% (259/354) routinely scavenged WAG during CPB cases. Only 6.6% of the respondents (22/336) conducted environmental monitoring for WAG levels. Cited reasons for not scavenging waste gases included a lack of applicable protocols and waste gas scavenging systems, excessive cost, and no need for scavenging.
CONCLUSIONS: Our findings identify a gap between AmSECT guidelines and current perfusionist behavior and suggest potential strategies for reducing WAG leakage during CPB. Effective management should incorporate hazard awareness training, availability of standard procedures to minimize exposure, scavenging systems, regular equipment inspection, and prompt attention to spills and leaks. In high-risk environments, environmental surveillance for waste gas levels would also contribute to waste gas safety. A comprehensive approach to managing waste anesthetic gases will reduce WAG leakage, help improve health care worker safety, and prevent potential adverse effects of exposure.
METHODS: We developed a questionnaire with 26 questions covering institutional demographics, use of anesthetic gases, scavenging systems, and air monitoring practices.
METHODS: Web-based survey.
METHODS: Self-identified board-eligible perfusionist members of AmSECT, the American Academy of Cardiovascular Perfusion, and the Maryland and Wisconsin State Perfusion Societies in 2022.
METHODS: None.
RESULTS: Of the 4,303 providers sent the survey, 365 (8.5%) participated. Although 92% of the respondents (335/364) routinely administered inhaled anesthetics via the oxygenator, only 73.2% (259/354) routinely scavenged WAG during CPB cases. Only 6.6% of the respondents (22/336) conducted environmental monitoring for WAG levels. Cited reasons for not scavenging waste gases included a lack of applicable protocols and waste gas scavenging systems, excessive cost, and no need for scavenging.
CONCLUSIONS: Our findings identify a gap between AmSECT guidelines and current perfusionist behavior and suggest potential strategies for reducing WAG leakage during CPB. Effective management should incorporate hazard awareness training, availability of standard procedures to minimize exposure, scavenging systems, regular equipment inspection, and prompt attention to spills and leaks. In high-risk environments, environmental surveillance for waste gas levels would also contribute to waste gas safety. A comprehensive approach to managing waste anesthetic gases will reduce WAG leakage, help improve health care worker safety, and prevent potential adverse effects of exposure.
摘要：
目的：描述灌注医师对体外循环（CPB）期间废弃麻醉气体（WAG）管理的观点，并将结果与现有的美国体外技术学会（AmSECT）指南和2016年美国职业安全与健康研究所对医护人员和麻醉护理提供者的调查进行比较。
方法：我们开发了一份包含26个问题的问卷，涵盖了机构人口统计学，使用麻醉气体，清除系统,和空气监测实践。
方法：基于Web的调查。
方法：自我鉴定的符合董事会资格的AmSECT灌注师成员，美国心血管灌注学会，以及2022年的马里兰州和威斯康星州灌注协会。
方法：无。
结果：在发送调查的4,303家提供商中，365人（8.5%）参加。尽管92%的受访者（335/364）通过充氧器常规给予吸入麻醉药，只有73.2%(259/354)在CPB病例期间常规清除WAG。只有6.6％的受访者（22/336）对WAG水平进行了环境监测。未清除废气的引用原因包括缺乏适用的协议和废气清除系统，成本过高,也不需要清理。
结论：我们的发现确定了AmSECT指南与当前灌注者行为之间的差距，并提出了减少CPB期间WAG泄漏的潜在策略。有效管理应纳入危害意识培训，标准程序的可用性，以尽量减少暴露，清除系统,设备定期检查,并迅速注意泄漏和泄漏。在高风险环境中，对废气水平的环境监测也将有助于废气安全。管理废弃麻醉气体的综合方法将减少WAG泄漏，帮助提高医护人员的安全，并防止暴露的潜在不利影响。
方法：我们开发了一份包含26个问题的问卷，涵盖了机构人口统计学，使用麻醉气体，清除系统,和空气监测实践。
方法：基于Web的调查。
方法：自我鉴定的符合董事会资格的AmSECT灌注师成员，美国心血管灌注学会，以及2022年的马里兰州和威斯康星州灌注协会。
方法：无。
结果：在发送调查的4,303家提供商中，365人（8.5%）参加。尽管92%的受访者（335/364）通过充氧器常规给予吸入麻醉药，只有73.2%(259/354)在CPB病例期间常规清除WAG。只有6.6％的受访者（22/336）对WAG水平进行了环境监测。未清除废气的引用原因包括缺乏适用的协议和废气清除系统，成本过高,也不需要清理。
结论：我们的发现确定了AmSECT指南与当前灌注者行为之间的差距，并提出了减少CPB期间WAG泄漏的潜在策略。有效管理应纳入危害意识培训，标准程序的可用性，以尽量减少暴露，清除系统,设备定期检查,并迅速注意泄漏和泄漏。在高风险环境中，对废气水平的环境监测也将有助于废气安全。管理废弃麻醉气体的综合方法将减少WAG泄漏，帮助提高医护人员的安全，并防止暴露的潜在不利影响。
