August 2022
In your institution, how often is a processed-EEG used for monitoring the depth of anesthesia in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass?
A.) Always – ( 8 votes )
B.) Sometimes – ( 24 votes )
C.) Never – ( 55 votes )
Total Answers 87
Total Votes 87
July 2022
In your institution, how often is a peritoneal dialysis catheter inserted into neonates following complex repair requiring cardiopulmonary bypass?
A.) Always – ( 28 votes )
B.) Sometimes – ( 58 votes )
C.) Never – ( 30 votes )
Total Answers 116
Total Votes 116
June 2022
At your hospital, which viscoelastic test is available during cardiac cases requiring cardiopulmonary bypass to help determine blood product transfusion needs?
A.) TEG 5000 – ( 34 votes )
B.) TEG 6S – ( 19 votes )
C.) ROTEM – ( 43 votes )
D.) Quantra – ( 1 vote )
E.) Sonoclot – ( 0 votes )
F.) Other – ( 2 votes )
G.) None – ( 32 votes )
Total Answers 131
Total Votes 131
May 2022
Does your hospital have a peer support program for physicians following adverse events? Select all that apply
A) Yes – we have a hospital-based peer support program – ( 40 votes )
B) Yes – we have a cardiac specific peer support program – ( 1 vote )
C) No – ( 60 votes )
Total Answers 101
Total Votes 97
April 2022
How often do you use manometry to verify venous placement of a central line performed with ultrasound guidance?
A) Always – ( 24 votes )
B) Sometimes – ( 31 votes )
C) Never – ( 74 votes )
Total Answers 129
Total Votes 129
March 2022
At your institution, what is the most common initial non-intravenous pharmacologic prophylaxis against shunt thrombosis in patients with a modified Blalock Taussig shunt? (Select all that apply if combination therapy)
A) Aspirin – ( 125 votes )
B) Plavix – ( 10 votes )
C) Lovenox – ( 16 votes )
D) Other – ( 6 votes )
Total Answers 157
Total Votes 139
February 2022
At your hospital, what is the minimum time that Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors) are held prior to elective surgery?
A) 12 hours – ( 53 votes )
B) 24 hours – ( 75 votes)
C) 48 hours – ( 6 votes )
D) Not routinely held – ( 36 votes )
Total Answers 169
Total Votes 169
January 2022
At your institution, is a nitroglycerin infusion used routinely during a neonatal arterial switch operation?
A) Always – ( 30 votes )
B) Never – ( 83 votes )
C) Sometimes – ( 48 votes )
Total Answers 161
Total Votes 161
December 2021
At your institution, how often are in-line filters used in infusion tubing during the anesthetic care of congenital cardiac patients?
A) Always – ( 56 votes )
B) Sometimes – ( 36 votes )
C) Never – ( 52 votes )
Total Answers 144
Total Votes 144
November 2021
In your routine practice, do you replete potassium in the cardiac operating room?
A) Yes. If K+ < 3.0 mmol/L – ( 47 votes )
B) Yes. If K+ < 2.5 mmol/L – ( 26 votes )
C) Occasionally, but only if the patient is experiencing significant ectopy or arrhythmias – ( 35 votes )
D) Never – ( 21 votes )
Total Answers 129
Total Votes 129
October 2021
At your institution, where are routine delayed sternal closures done after surgery for neonatal/infant cardiac surgery such as a Norwood or arterial switch operation?
A) In the cardiac operating room – ( 21 votes )
B) At bedside in the ICU – ( 112 votes )
C) Depends on the patient – ( 31 votes )
Total Answers 164
Total Votes 164
September 2021
At your institution, which of the following regional or neuraxial techniques are you or the surgical team utilizing routinely in your pediatric cardiac surgical patients? (Choose all that apply)
A) Single shot caudal injection with opioid – ( 20 votes )
B) Single shot spinal injection with opioid – ( 3 votes )
C) Erector spinae plane block – ( 43 votes )
D) Paravertebral block – ( 9 votes )
E) Serratus anterior plane block – ( 3 votes )
F) Pectoralis I (PEC I) nerve block I/Pectoralis II (PEC II) nerve block – ( 9 votes )
G) Pecto-Intercostal Fascial (PIF) block/Transversus Thoracic Muscle Plane (TTMP ) block – ( 7 votes )
H) Thoracic Epidural Catheter – ( 17 votes )
I) Parasternal nerve blocks – ( 10 votes )
J) Intercostal nerve blocks – ( 12 votes )
Total Answers 133
Total Votes 85
August 2021
Does your institution have a formal pediatric Patient Blood Management (PBM) program consisting of a multidisciplinary team that oversees implementation of blood management protocols, such as pre-operative anemia guidelines?
A) Yes – ( 27 votes )
B) No – ( 74 votes )
Total Answers 101
Total Votes 101
July 2021
At your hospital, when are formal transesophageal echocardiograph readings performed for pediatric patients undergoing cardiac surgery on cardiopulmonary bypass?
A) Pre-bypass only – ( 0 votes )
B) Pre-bypass and Post-bypass – ( 149 votes )
C) Post-bypass only – ( 22 votes )
D) Not performed – ( 9 votes )
Total Answers 180
Total Votes 180
June 2021
At your hospital, does the perfusion team target different PaO2 ranges while on cardiopulmonary bypass for cyanotic versus non-cyanotic infants and children undergoing cardiac surgery?
A) Yes – ( 30 votes )
B) No – ( 57 votes )
Total Answers 87
Total Votes 87
May 2021
Seizures have been observed to occur in 8% of neonates after cardiac surgery with cardiopulmonary bypass, and the majority are subclinical. Is continuous electroencephalographic (EEG) monitoring used perioperatively at your institution in neonatal cardiac surgical patients?
A) Yes, routinely used in all neonates intraoperatively and postoperatively.- ( 7 votes )
B) Yes, routinely used in all neonates postoperatively. – ( 12 votes )
C) Yes, routinely used in all neonates postoperatively but only if requiring continuous neuromuscular blockade. – ( 1 vote )
D) Yes, but only if the patient exhibits symptoms of a seizure or new neurologic deficit. – ( 40 votes )
E) No, continuous EEG is never utilized. – ( 23 votes )
Total Answers 83
Total Votes 83
April 2021
For webinars presented by the CCAS throughout the year, when are you most likely to participate in these lectures based on US Eastern Standard Time? Please select all that apply.
A) Weekday evenings (6-8PM) – ( 73 votes )
B) Saturday morning (10-Noon) – ( 64 votes )
C) Saturday afternoon (1-3PM) – ( 12 votes )
D) Saturday afternoon (3-5PM) – ( 16 votes )
E) Sunday morning (10-Noon) – ( 28 votes )
Total Answers 193
Total Votes 152
March 2021
At your hospital, does the blood bank have the ability to concentrate platelets for use in neonates undergoing cardiac surgery?
A) Yes – ( 91 votes )
B) No – ( 106 votes )
Total Answers 197
Total Votes 197
February 2021
For pediatric patients undergoing cardiac surgery at your institution, which patients are tested for COVID-19 preoperatively?
A) All patients – ( 191 votes )
B) Only symptomatic patients – ( 16 votes )
C) No testing is routinely performed – ( 8 votes )
Total Answers 215
Total Votes 215
January 2021
If your institution is testing patients for coronavirus, do neonates who will be undergoing anesthesia for cardiac surgery or cardiac catheterization lab procedures get tested for coronavirus preoperatively?
A) No – ( 23 votes )
B) Only after 48 hours of birth, considered negative until then – ( 19 votes )
C) Always – ( 125 votes )
Total Answers 167
Total Votes 167
December 2020
For pediatric cardiac patients undergoing an anesthetic, what is your current practice for the minimal acceptable NPO time for clear liquids before induction:
A) One hour – ( 68 votes )
B) Two hours – ( 202 votes )
C) 3 hours or more – ( 15 votes )
Total Answers 285
Total Votes 285
November 2020
In comparison to before the COVID-19 pandemic, the pediatric cardiac surgical case volume at my institution during the COVID-19 pandemic has:
A) Increased – ( 20 votes )
B) Decreased – ( 68 votes )
C) Stayed the same – ( 73 votes )
Total Answers 161
Total Votes 161
October 2020
At your institution, compared to a pediatric anesthesiologist working in the non-cardiac operating rooms, the base salary of a pediatric cardiac anesthesiologist is:
A) Lower – ( 12 votes )
B) The Same – ( 185 votes )
C) Higher – ( 91 votes )
Total Answers 288
Total Votes 288
September 2020
At your institution, at what level of glucose (mg/dL) do you routinely begin to treat intraoperative hyperglycemia for pediatric patients undergoing cardiopulmonary bypass?
A) 140 – ( 6 votes )
B) 200 – ( 68 votes )
C) 300 – ( 67 votes )
D) 400 or greater – ( 18 votes )
E) Intraoperative hyperglycemia is not routinely treated at my institution. – ( 59 votes )
Total Answers 218
Total Votes 218
August 2020
In your current practice, do you use a single-shot caudal or epidural anesthetic technique for pediatric patients undergoing cardiopulmonary bypass?
A) Always – ( 5 votes )
B) Sometimes – ( 37 votes )
C) Never – ( 190 votes )
Total Answers 232
Total Votes 232
July 2020
What is your preferred topic for the 2021 CCAS program?
A) Regional Anesthesia for Cardiac Procedures – ( 58 votes )
B) Point of Care Ultrasound in Congenital Heart Disease – ( 51 votes )
C) Cath Lab Interventions in Neonates – ( 38 votes )
D) Adult Congenital Heart Disease – ( 29 votes )
Total Answers 176
Total Votes 176
June 2020
At your hospital, do you routinely use a cerebral oximeter during cases in the interventional cardiac catheterization lab?
A) Always – ( 14 votes )
B) Sometimes – greater than 50% of the time – ( 10 votes )
C) Sometimes – less than 50% of the time – ( 91 votes )
D) Never – ( 97 votes )
Total Answers 212
Total Votes 212
May 2020
What is the top priority for congenital cardiac anesthesia research?
A) Neurologic Outcomes – ( 92 votes )
B) Bleeding and Transfusion – ( 27 votes )
C) Big Data and Outcomes – ( 44 votes )
D) Regional and Pain – ( 7 votes )
Total Answers 170
Total Votes 170
April 2020
In response to the COVID-19 pandemic, guidelines have been published recommending rapid sequence induction (RSI) for patients with suspected or confirmed COVID-19 in order to avoid potential aerosolization of the virus with manual ventilation. At your hospital, are you performing an RSI for pediatric patients with congenital heart disease undergoing general anesthesia?
A) Yes – for all patients (asymptomatic and suspected/confirmed COVID-19) – ( 44 votes )
B) Yes – but only for patients with suspected/confirmed COVID-19 – ( 90 votes )
C) No – not unless clinically indicated or an emergency – ( 79 votes )
Total Answers 213
Total Votes 213
March 2020
In a 4-day-old with congenital heart disease undergoing cardiopulmonary bypass, would you use an umbilical venous catheter that has been confirmed to be in the proper position at the junction of the inferior vena cava and right atrium as central venous access during the case?
A) Always – ( 63 votes )
B) Sometimes – ( 111 votes )
C) Never – ( 54 votes )
Total Answers 228
Total Votes 228
February 2020
At your institution, what type of vascular access is preferred for vasoactive infusions in a 3 kg full term neonate undergoing cardiopulmonary bypass?
A) Intracardiac line – ( 39 votes )
B) PICC line – ( 9 votes )
C) Femoral Central venous line – ( 43 votes )
D) Internal Jugular Central venous line – ( 165 votes )
E) Other – ( 7 votes )
Total Answers 263
Total Votes 263
January 2020
In pediatric patients with a cavopulmonary anastomosis undergoing cardiopulmonary bypass, where is your first choice for placement of the central line?
A) Internal Jugular Vein – ( 138 votes )
B) Femoral Vein – ( 80 votes )
C) Other – ( 11 votes )
Total Answers 229
Total Votes 229
December 2019
In pediatric patients with congenital heart disease undergoing cardiopulmonary bypass, what is your first line of treatment for heparin resistance in order to achieve proper anticoagulation for bypass?
A) Additional Heparin Dose – ( 106 votes )
B) Fresh Frozen Plasma – ( 119 votes )
C) Antithrombin III Concentrate (Thrombate) – ( 56 votes )
D) Other – ( 6 votes )
Total Answers 287
Total Votes 287
November 2019
In neonates with congenital heart disease undergoing cardiopulmonary bypass, do you check an antithrombin III level with pre-operative labs at your hospital?
A) Always – ( 18 votes )
B) Never – ( 126 votes )
C) Sometimes – ( 53 votes )
Total Answers 197
Total Votes 197
October 2019
Do you use social media? Choose ALL that apply.
A) Facebook – ( 112 votes )
B) Twitter – ( 30 votes )
C) LinkedIn – ( 47 votes )
D) None – ( 74 votes )
Total Answers 263
Total Votes 263
September 2019
At your institution, are prothrombin complex concentrates, such as KCentra, used to manage bleeding after cardiopulmonary bypass for congenital heart surgery?
A) Always – ( 5 votes )
B) Never – ( 127 votes )
C) Sometimes – ( 100 votes )
Total Answers 232
Total Votes 232
August 2019
At your institution, are dexmedetomidine infusions used for sedation in the PACU following cardiac catheterization?
A) Always – ( 11 votes )
B) Sometimes – ( 118 votes )
C) Never – ( 98 votes )
Total Answers 227
Total Votes 227
July 2019
In your current practice, who provides coverage in the cardiac catheterization lab?
A) Pediatric Cardiac Anesthesiologist – ( 146 votes )
B) Pediatric Anesthesiologist – ( 18 votes )
C) Both A and B – ( 99 votes )
Total Answers 263
Total Votes 263
June 2019
In your current practice, do you use an ultrasound during the initial attempt to place arterial lines in pediatric patients?
A) Always – ( 73 votes )
B) Never – ( 25 votes )
C) Sometimes – ( 103 votes )
Total Answers 201
Total Votes 201
May 2019
In your current practice, do you use an ultrasound during the initial attempt to place central venous lines in pediatric patients?
A) Always – ( 245 votes )
B) Never – ( 10 votes )
C) Sometimes – ( 32 votes )
Total Answers 287
Total Votes 287
April 2019
At your institution, who performs PDA ligations/occlusions for neonates and infants >2.5 kg?
A) Congenital Cardiac Surgery – ( 244 votes )
B) Pediatric General Surgery – ( 32 votes )
Total Answers 276
Total Votes 276
March 2019
At your institution, for neonates undergoing aortic coarctation repair of a left sided arch through a thoracotomy incision, where do you place the arterial line for the procedure?
A) Right radial artery only – ( 158 votes )
B) Femoral artery only – ( 11 votes )
C) Both right radial and femoral arteries – ( 71 votes )
Total Answers 240
Total Votes 240
February 2019
In your current practice, for pediatric patients undergoing cardiac surgery using cardiopulmonary bypass, what type of access do you use to administer protamine?
A) Peripheral IV – ( 91 votes )
B) Central Line – ( 77 votes )
Total Answers 168
Total Votes 168
January 2019
At your institution, external defibrillation (R2) pads are placed on the patient in the following CPB cases:
A) All cases – ( 30 votes )
B) Redo cases – ( 185 votes )
C) Case-by-case basis – ( 23 votes )
Total Answers 238
Total Votes 238
December 2018
For pediatric patients with congenital heart disease undergoing cardiopulmonary bypass surgery, which antifibrinolytic medication is used at your hospital?
A) Aprotinin – ( 3 votes )
B) Tranexamic acid – ( 172 votes )
C) Aminocaproic Acid – ( 46 votes )
D) No antifibrinolytic medications are used – ( 11 votes )
Total Answers 232
Total Votes 232
November 2018
After you fail at placing a radial arterial line, you attempt placing a catheter in:
A) The ulnar artery on the opposite side – ( 7 votes )
B) The ulnar artery on the same side if there is a documented radial pulse on ultrasound – ( 40 votes )
C) The radial artery on the opposite side – ( 239 votes )
Total Answers 286
Total Votes 286
October 2018
For an 8yo with a normal airway and an uneventful intraoperative course undergoing a cardiac catheterization procedure, would you extubate the patient under a deep plane of anesthesia in an effort to avoid bleeding at catheter insertion sites?
A) Always – ( 124 votes )
B) Never – ( 41 votes )
C) Sometimes – ( 98 votes )
Total Answers 263
Total Votes 263
September 2018
After coming off cardiopulmonary bypass, the TEE probe is:
A) Routinely removed when the cardiologist is done with the exam – ( 80 votes )
B) Routinely kept in place until chest closure – ( 93 votes )
C) Kept in place only in specific concerning cases – ( 64 votes )
Total Answers 237
Total Votes 237
August 2018
In neonates undergoing cardiac surgery, do you use an ICU-type ventilator in the operating room?
A) Never – ( 52 votes )
B) Always – ( 10 votes )
C) Only if the neonate is inadequately ventilating on the anesthesia machine ventilator – ( 154 votes )
Total Answers 216
Total Votes 216
July 2018
At your institution, delayed chest closure is performed:
A) In the operating room – ( 68 votes )
B) At the bedside in the ICU and managed by the intensivist – ( 76 votes )
C) At the bedside in the ICU and managed by the anesthesiologist – ( 123 votes )
Total Answers 267
Total Votes 267
June 2018
Question: In neonates with congenital heart disease scheduled for cardiac repair, in your current practice do you perform nasal intubations as long as there is not an immediate contraindication?
A) Always – ( 70 votes )
B) Sometimes – ( 52 votes )
C) Never – ( 134 votes )
Total Answers 256
Total Votes 256
May 2018
In patients with congenital heart disease scheduled for noncardiac surgery, do you hold the dose of diuretic medications the morning of surgery?
A) Always – ( 73 votes )
B) Sometimes – ( 151 votes )
C) Never – ( 66 votes )
Total Answers 290
Total Votes 290
April 2018
What is your practice for infants undergoing a pre-Glenn hemodynamic catheterization?
A) Natural airway, with or without nasal cannula – ( 13 votes )
B) LMA, spontaneous ventilation – ( 26 votes )
C) ETT, spontaneous ventilation – ( 28 votes )
D) ETT, controlled ventilation – ( 198 votes )
Total Answers 265
Total Votes 265
March 2018
The most common inotrope I use for prevention of low cardiac output syndrome (LCOS) in infants is:
A) Milrinone – ( 79 votes )
B) Epinephrine – ( 56 votes )
C) Dopamine – ( 25 votes )
D) A combination of the above – ( 156 votes )
E) None of the above – ( 4 votes )
Total Answers 320
Total Votes 320
February 2018
For neonates undergoing the Stage 1 Norwood Procedure, what is your PRIMARY method for anesthetic maintenance:
A) Volatile agent – ( 79 votes )
B) Narcotics – ( 172 votes )
C) Ketamine – ( 9 votes )
D) Dexmedetomidine – ( 6 votes )
E) Other – ( 6 votes )
Total Answers 272
Total Votes 272
January 2018
Do you use protamine to reverse unfractionated heparin anticoagulation in the catheterization laboratory?
A) Always – ( 14 votes )
B) Never – ( 92 votes )
C) Based on the ACT level – ( 128 votes )
Total Answers 234
Total Votes 234
December 2017
Do you continue the infusion of antifibrinolytic agents DURING periods of reduced or no flow associated with circulatory arrest or antegrade cerebral perfusion?
A) Yes – ( 91 votes )
B) No – ( 37 votes )
C) Yes, at a reduced rate – ( 4 votes )
D) Antifibrinolytics are not used in these cases – ( 13 votes )
Total Answers 145
Total Votes 145
November 2017
Which of the following would you consider placing in the operating room for a neonate less than 1 week of age presenting for cardiac surgery?
A) Umbilical Artery Catheter (UAC) only – ( 6 votes )
B) Umbilical Venous Catheter (UVC) only – ( 5 votes )
C) Both UAC and UVC – ( 40 votes )
D) Neither – ( 145 votes )
Total Answers 196
Total Votes 196
October 2017
In order to place an upper extremity arterial line in a child less than 5 kg without umbilical arterial access, what method do you utilize for the FIRST ATTEMPT:
A) Palpation – ( 87 votes )
B) Ultrasound – ( 193 votes )
C) Cut-down by anesthesia – ( 3 votes )
D) Cut-down by surgery staff – ( 10 votes )
E) Doppler – ( 6 votes )
Total Answers 299
Total Votes 299
September 2017
What modes of neurocognitive monitoring for cardiopulmonary bypass cases are used on a routine basis at your institution?
A) transcranial doppler – ( 1 votes )
B) near-infrared spectroscopy (NIRS) – ( 174 votes )
C) jugular venous O2 saturation – ( 1 votes )
D) no neurocognitive monitors are used – ( 12 votes )
E) more than one of the above modalities are used in combination – ( 7 votes )
Total Answers 195
Total Votes 195
August 2017
At your hospital during vascular ring repairs performed through a thoracotomy incision on an otherwise healthy three year old, are regional anesthetic techniques used for post-operative pain control?
A) No – ( 28 votes )
B) Yes, the anesthesia team performs a paravertebral block or thoracic epidural – ( 57 votes )
C) Yes, the surgeon performs an intercostal nerve block – ( 63 votes )
Total Answers 148
Total Votes 148
July 2017
In a patient with Williams-Beuren syndrome who has undergone an uncomplicated, simple non-cardiac anesthetic (eg. MRI), what is the most common postoperative disposition?
A) Discharge as an outpatient – ( 58 votes )
B) Admit the patient for 24 hours observation – ( 41 votes )
C) Disposition is dependent on extent of outflow tract obstruction and coronary artery ostial compromise – ( 109 votes )
Total Answers 208
Total Votes 208
June 2017
At your hospital during Stage I/Sano, where is the preferred placement of central lines?
A) Internal jugular vein – ( 104 votes )
B) Subclavian vein – ( 6 votes )
C) Femoral vein – ( 53 votes )
D) Intracardiac line – ( 70 votes )
Total Answers 233
Total Votes 233
May 2017
What hemostatic agent is used for “rescue therapy”, defined as situations in which patients continue to bleed excessively following cardiopulmonary bypass despite having received maximal standard hemostatic therapy?
A) Recombinant factor VIIa – ( 210 votes )
B) 3-Factor prothrombin complex concentrates (e.g. Profilnine SD, Bebulin) – ( 9 votes )
C) 4-Factor prothrombin complex concentrates (e.g. Beriplex, Kcentra) – ( 22 votes )
D) None of the above – ( 5 votes )
Total Answers 246
Total Votes 246
April 2017
For an otherwise healthy 11-year-old undergoing an electrophysiology procedure to ablate a WPW pathway, which of the following anesthetic techniques would be employed?
A) General Anesthesia with inhalational maintenance – ( 88 votes )
B) General Anesthesia with Total Intravenous Anesthesia (TIVA) – ( 65 votes )
C) General Anesthesia with combination of inhalational and IV agents – ( 85 votes )
D) Monitored Anesthetic Care – ( 21 votes )
Total Answers 259
Total Votes 259
March 2017
Do you use Point of Care Testing (TEG or ROTEM) to guide transfusion for patients undergoing cardiac surgery?
A) Routinely pre and post bypass – ( 31 votes )
B) Routinely post bypass only – ( 9 votes )
C) In select cases pre and post bypass – ( 35 votes )
D) In select case post bypass only – ( 31 votes )
E) Never – ( 68 votes )
Total Answers 176
Total Votes 176
February 2017
At your institution, after stage 1 repair with mBT or Sano shunt
A) G-tubes are performed routinely prior to extubation after primary palliation – ( 5 votes )
B) G-tubes are performed after extubation and trial of oral feeding – ( 40 votes )
C) NG or OG tubes are placed until second stage palliation or until oral feeding is resumed – ( 26 votes )
D) No protocol, case by case basis – ( 137 votes )
Total Answers 209
Total Votes 209
January 2017
As a pediatric cardiac anesthesiologist, how often do you utilize the TEE probe to assess function or conduct an anatomic exam after the cardiologist has finished their exam?
A) Never – ( 97 votes )
B) Always – ( 61 votes )
C) In select cases only- ( 81 votes )
Total Answers 244
Total Votes 244
