1	In neonates or preterms, we also use the following tubing combination: 1/8–1/8
2	The part about the cardioplegia do not include the hyperpotassic cold blood cardiolpegia; for this reason, my answer is not clear
3	Great job!
4	…
5	Good job! Really:)
6	We use mI/kg/min and CI. We use flow rate necessary to close aortic valve with close attention to delivery pressure, ECG, etc. and communication to the surgeon during plegia. We use a range for HCT depending on the case and anomaly, rather than temperature, but temperature is always considered with circulatory arrest or SCP. The questions worded what determines combination of tubing needed further
7	One or two questions could be improved. “What time” in the CPG section was completely undefinable?
8	Cardioplegia dosing should have maximum amount and maximum flow rate or pressure, etc. for induction and maintenance
9	Flows during hypothermia are based on adequacy of perfusion markers, not just temp. Rewarming temperature for us is venous temperature, do not care what other temperatures read. We have found inaccurate temperatures when using rectal/bladder. Survey could be more complete/accurate if allowed to enter information, not just numbers in some fields. Some answers need an explanation
10	For the CPB-related questions, specify with/without cross-clamp for pressure monitoring. Please reach out to me for any clarification
11	There were questions on the FT staff of pediatric surgeons and anesthesiologists, but not percussionists. I would have liked to see these data included in the survey too
12	Our HCT protocol is not based on what temperature we cool to, but rather patient age and pathology. Patients younger than 1 year of age: Minimal HCT is 30% on CPB and 35% weaning off CPB. Greater than 1 year minimal HCT is generally 24% but will consider SVO2, NIRS, ABP, etc before pulling the trigger. Single ventricle patients: Minimal HCT is 30% on CPB and 35% weaning off CPB, regardless of age
13	With four surgeons, we use three different cardioplegia delivery techniques, from Plegisol, del Nido, Custodiol HTK, and so on. My responses were mostly for the del Nido delivery because it asked about blood/crystalloid ratio
14	Too many required fields. Flaw in the survey is that there is no way to enter the different surgeon protocols at same instant. I have 3 surgeons doing things 3 different ways! 2 years until i retire
15	Temperature fields that are not used by our institution should have N/A option, instead of forced value. Same for selective cerebral perfusion area.
16	Our definition of prime is the circuit volume which hemodilutes patient blood when going on CPB. Because the cardioplegia in our circuit does not, we object to this survey definition of pump prime calculation
17	Great survey. I look forward to seeing the results. A lot of these questions relate to topics of disagreement among colleagues or even other institutions. Thank you!
18	Difficult to answer flow rate questions because they are based on age/weight, not temperature
19	No selection for multiple surgeons who do things differently
20	We use equal St. Thomas and del Nido CPG, which could only select one set of parameters, so we could not provide information regarding our del Nido CPG
21	Under ultrafiltration, we do V-AMUF (SMUF). Our data of capture rate are 1 sec, but our record is captured in 1-m intervals
22	Percentage of time you infuse cardioplegia: I took this to mean percent of cases using cardioplegia. Phasing out measuring routine Lactate levels as we migrate to the iSTAT and occasionally using the Dideco D736 arterial filter for neonates. Great job!! Sorry this was so late
23	I used “0” in numeric fields as N/A. Also, I do not have the neo vs. pediatric breakouts
24	For some items, it would have been naive to put ranges (e.g., temperatures, hematocrits). What was the “time” portion of the cardioplegia asking—time for redoes, time over which the initial does was given
25	Most of the clinical/protocol questions are surgeon-specific versus protocol-driven, that is, Hgb/HCT for various temperatures, CPG flow, pressures, blood priming, etc.—there should be a caveat to explain this in the selection above
26	We have two surgeons who use very different parameters for blood flow and temperature limits in regard to circulatory arrest. Because of the limitations of the answer field, I was only able to answer in reference to one surgeon, that is, 18°C or 18°C or 28°C
27	What is the lowest patient weight (kg) you would consider a bloodless initiation of bypass? I answered 6 kg—decision based more on calculated dilutional HCT, degree of cooling, and patient lesion
28	Thank you very much for this survey. I might suggest fewer mandatory fields
29	Difficult to commit to hard number of sometimes for “limits,” as patients vary. Well put together, survey is an excellent work
30	Often a lot of times, our temperatures are more on a range depending on patient and their operative course. Also, flows vary on many other factors like BP, NIRS, lactate, and venous saturation; often, we flow much more than our BSA guideline recommends, or less during profound cooling, anesthesia treats glucose
31	Cardioplegia subsequent dose wrong label. Temperatures should have had arterial vs ventral temperature in-line sensors says measured not calc....but all are calc. neonate prime blood-can be both irradiated and citrated. Overall good survey!
32	Was there supposed to be a question regarding cardioplegia delivery pressure? It is mentioned in the section heading, but there was no specific question. I did not like the question of cardioplegia initial flow in ml/kg/min
33	Protocols vary from a 1-year-old to an 18-year-old, resulting in inconsistent response (i.e., blood prime) is the cardioplegia K+concentration that of the crystalloid component or delivered solution?
34	Cardioplegia additives: We use Custodial. Flow rates: 2.6 cardiac index used for patient over 10 kg. Do not monitor oral/other temperatures
35	I was unsure of the question asking how many times VAD was used in 2016 for post-cardio to my support. We only use ECMO support post-cardiotomy. I figured you might have meant for ECMO to be included, but also thought if you wanted ECMO support, it would have been worded “VAD/ECMO.” We did 7 VAD implants in 2016, but none were post-cardiotomy, so I answered 0. We probably initiated 7 ECMO supports post-cardiotomy in 2016
36	Some choices for blood prime, flow rates, etc. are surgeon- and case-dependent, but I did my best to describe the most common scenarios. I was forced to enter values for temperatures that we do not monitor, so I entered 0
37	For the question, “When using the following ranges of hypothermia, what flow rate do you use?,” mL/kg/min is not constant between neonates and adults. Possibly revise
38	1. No ACTs on bypass, heparin concentration measured with ABGs every 20–30 minutes. ACT only pre- and post-bypass and following heparin does prior to bypass.
	2. CP flow rate is pressure-dependent.
	3. “Lowest patient weight (kg) you would consider a bloodless initiation of bypass?” depends on the procedure being done and calculated hemodilution.
	4. HCT prior to termination varies and does not account for final HCT after minimum of 10 minutes of V-VMUF
39	Very nice survey. There are a feq “it depend” questions that do not allow for flexibility. for example, blood product use depends on the HCT and procedure. Flow rates (at temperature)...we use an age-adjusted scale for flow calculations. CPG depends on the case and surgeon. Only one pathway available once selected. I assume it is implied to report the most common. Difference in conventional and non-conventional work days. CPG additives, not a none option. Not able to capture all the things people are doing, but a very nicely designed survey. Thank you
40	We used 3 VADs for support to transplant and 1 for support to home
41	Some answers could change by patient size, for example, flow rate calculation/temperature section. Patient flow does decrease by size. I answered using neo/peds, However, we use flow high on all patients. Circulation is preferred over nought
42	When using “low flow” bypass, we roughly follow the degree of hypothermia for flow rate
43	We are a satellite program of Seattle Children’s. Until 2016, we were able to prime our smaller circuits with citrated whole blood; it was great! Currently, we routinely blood prime for all children less than 10 kg. We attempt clear primes on kids greater than 10 kg
44	Under VAD types you included ECLS; is ECLS included in the question about post-cardiotomy VAD usage? This was unclear
45	I think each subset has a comments section just to address some answers that did not fit exactly into the provided answers
46	When asking questions about flow at certain temperatures, we should specify what weight/age-group as flows for neonates at 32°C which would be different to flows for 14-year-olds at 32°C. Also minimum weight to consider bloodless prime depends on patients stating hematocrit as well as weight
47	We use body surface area (m2) for plegia
48	To what core temperature, do you typically cool the patient when you use the following: Low flow depends on how long you are taking for low flow.
49	To what core temperature do you typically cool the patient when you use the following: Low flow depends on how long you are taking for low flow