Standards of care in perfusion: should not continuous in-line blood gas monitoring be one?

What is a standard of care? Who defines standard of care? And when does new technology, such as continuous in-line blood gas monitoring (CILBGM), become a standard of care? Perhaps the most productive and practical way to view standards of care in perfusion is as, "the best perfusion management we can provide for our patients within reason and affordability." Today, CILBGM offers a tangible patient care benefit to perfusion management-real-time, continuous monitoring of the patient's physiologic responses to cardiopulmonary bypass, allowing the perfusionist to adjust bypass accordingly. At less than $200 per case, CILBGM is not excessively priced. Certain basic standards of practice for perfusion, along with the commitment to actively investigate new techniques and equipment, could help assure quality in patient care. If, as in the case of CILBGM, new technology contributes materially to the safety and well-being of a patient, we would be remiss not to endorse it as a standard of quality care.