{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:49:13Z","timestamp":1792144153694,"version":"4.4.0"},"reference-count":0,"publisher":"Armed Forces Medical Services","issue":"2","license":[{"start":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T00:00:00Z","timestamp":1770422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Saudi Medical Journal"],"abstract":"<jats:p>Objectives: To establish the[-28pc]AU: Add abbreviated academic degree for authors Fareed A. Khouqeer and Yasser A. Alheraish. first national standards and guidelines for best practice in perfusion for patients undergoing cardiothoracic surgery in Saudi Arabia. Cardiopulmonary bypass (CPB) enables complex cardiac surgeries; however, it poses risks of potential complications.\nMethods: We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop these guidelines and assess the certainty of evidence through a collaborative process. A panel of 16 Cardiovascu- lar perfusion experts across Saudi Arabia formulated 22 key clinical questions relevant to local practice. PubMed, Scopus, and Embase databases were searched for each question to identify relevant systematic reviews, randomized controlled trials (RCTs), non-randomized trials, post hoc analyses, and pooled analyses published from 2010 to 2024. The guideline panel voted for every question using the GRADEpro system, requiring a minimum consensus of 70% for approval.\nResults: A total of 16 conditional recommendations and 6 good practice statements were finally approved, categorized into 5 key domains. Of these, 4 addressed guidelines, protocols, and general practices; 2 focused on surgical techniques; 8 covered heart-lung machine hardware; 3 centered on cardioplegia and Priming Solutions; and 5 emphasized monitoring and perioperative management. Six statements were based on expert opinion due to insufficient supporting evidence. Using a standardized pre-bypass checklist to enhance safety and implementing perioperative glycemic management to control glucose levels and reduce complications were strongly recommended by the panel. Conditional recommendations focus on pump selection, biocompatible oxygenators, and continuous cerebral oxygenation monitoring. Anticoagulation, myocardial protection, and transfusion management were also highlighted.\nConclusion: These Saudi guidelines provide evidence-based recommendations to enhance the care of patients undergoing cardiac surgery with CPB, offering clear guidance for clinicians to achieve optimal outcomes. Nevertheless, future locally relevant research and regular updates are essential to bridge existing evidence gaps.<\/jats:p>","DOI":"10.15537\/1658-3175.1016","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T22:15:15Z","timestamp":1773958515000},"page":"336-401","source":"Crossref","is-referenced-by-count":0,"title":["National Heart Center Perfusion Guidelines"],"prefix":"10.15537","volume":"47","author":[{"given":"Fareed A.","family":"Khouqeer","sequence":"first","affiliation":[{"name":"Heart Center, King Faisal Specialist Hospital & Research Centre (KFSHRC), Riyadh, Saudi Arabia AND College of Medicine, Alfaisal University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz S.","family":"Albaradei","sequence":"additional","affiliation":[{"name":"Heart Center, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Jamjoom","sequence":"additional","affiliation":[{"name":"Heart Center, KFSHRC \u2013 Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husain H.","family":"Jabbad","sequence":"additional","affiliation":[{"name":"King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid A.","family":"Iskander","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Al Babtain Cardiac Center, Dhahran, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar M.","family":"Zainalabdeen","sequence":"additional","affiliation":[{"name":"Prince Sultan Cardiac Center (PSCC), Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser A.","family":"Alheraish","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, KFSHRC \u2013 Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebtesam M.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Academic and Training Department, PSCC, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman F.","family":"Alhumiany","sequence":"additional","affiliation":[{"name":"Cardiac Perfusion Department, King Abdullah Medical City, Makkah (Holy Capital), Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areej S. Al","family":"Buraiki","sequence":"additional","affiliation":[{"name":"Heart Center, KFSHRC \u2013 Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad W.","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Cardiac Perfusion, Madinah Cardiac Center, Ministry of Health, Madinah Al Munawarah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhamad I.","family":"Jelaldin","sequence":"additional","affiliation":[{"name":"Perfusion Services Unit, KFSHRC \u2013 Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab A.","family":"ZainAldeen","sequence":"additional","affiliation":[{"name":"Cardiac Perfusion Services, Saud Al-Babtain Cardiac Center \u2013 Eastern Health Cluster, Ministry of Health, Dammam, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bander A.","family":"Zamzami","sequence":"additional","affiliation":[{"name":"Cardiac Perfusion Services, King Abdulaziz Medical City \u2013 Ministry of National Guard Health A airs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Budoor S. Al","family":"Aujan","sequence":"additional","affiliation":[{"name":"Cardiac Perfusion Services, King Abdulaziz Medical City \u2013 Ministry of National Guard Health A airs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M. Galal","family":"Elsherbeny","sequence":"additional","affiliation":[{"name":"Cardiac Anesthesiologist, Prince Sultan Cardiac Center (PSCC), Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56029","published-online":{"date-parts":[[2026,2,7]]},"container-title":["Saudi Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/smj.researchcommons.org\/cgi\/viewcontent.cgi?article=1016&amp;context=journal","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:28:27Z","timestamp":1792142907000},"score":1,"resource":{"primary":{"URL":"https:\/\/smj.researchcommons.org\/journal\/vol47\/iss2\/17"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,7]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,7]]}},"URL":"https:\/\/doi.org\/10.15537\/1658-3175.1016","relation":{},"ISSN":["1658-3175"],"issn-type":[{"value":"1658-3175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,7]]}}}