Report of the 2022 Perfusion Perspectives of Waste Anesthetic Gas Exposure Survey

Objectives To describe perfusionist perspectives regarding waste anesthetic gas (WAG) management during cardiopulmonary bypass (CPB). To 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. Design We developed a questionnaire with 26 questions covering institution demographics, the utilization of anesthetic gases, scavenging systems, and air monitoring practices. Setting Web-based Survey Participants Self-identified board-eligible perfusionist members of AmSECT, the American Academy of Cardiovascular Perfusion, and the Maryland and Wisconsin State Perfusion Societies in 2022. Interventions None Measurements and Main Results 8.5% (365/4,303) participated in the survey. Although 92% (335/364) of respondents routinely administered inhaled anesthetics via the oxygenator, only 73.2% (259/354) routinely scavenge WAG during CPB cases. Only 6.6% of respondents (22/336) conducted environmental monitoring for WAG levels. Reasons for not scavenging waste gases included a lack of applicable protocols, waste gas scavenging systems, excess cost, and that scavenging was unnecessary. Conclusion 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 healthcare workers' safety, and prevent potential adverse effects of exposure.