The Cardiac Center at Joe DiMaggio Children's Hospital
Perfusion
Open heart surgery requires the collaboration of a team of doctors, nurses
and other allied health professionals to ensure a successful outcome. Each
of these team members has specific responsibilities throughout the operation.
One of the most important responsibilities is carried out by the perfusionist,
a specially trained expert who operates the heart-lung machine.
What Is Perfusion?
During some open heart operations, the patient’s heart and lungs must be
temporarily stopped to create a blood-free, motionless environment that
will make it possible for the surgeons to do the delicate work of cardiac
repair. The heart-lung machine keeps the patient alive during this time,
by doing the work of the heart and the lungs by artificial means until
it is time to allow them to resume functioning on their own. This artificial
process of keeping the body’s cells perfused (filled) with oxygen so that
the heart and lungs can stay at rest for an extended period of time is
called perfusion.
What Happens During Perfusion?
The surgeon, through the use of plastic tubing, diverts the patient’s blood
flow away from the heart and lungs and into the heart-lung machine, which
oxygenates the blood and pumps it back to the body in a continuous circuit.
As the blood travels through the body, it delivers fresh oxygen to every
cell and carries away carbon dioxide, just as if the patient’s heart and
lungs were doing all the work.
Throughout the process, the perfusionist controls the blood pressure, flow and temperature by adjusting the pump on the heart-lung machine. He or she continuously monitors the patient’s vital signs so that the patient’s condition is optimized during every stage of the operation.
Individualized Protocols
For the perfusionists at Joe DiMaggio Children’s Hospital, every patient
is respected as an individual with unique physiological needs. Variables
such as the patient’s age, size, condition and type of operation are all
taken into consideration so that the perfusion can be customized to the
situation at hand. The perfusionists also coordinate specialized care with
the other members of the cardiac team, including the doctors and nurses
in the cardiac intensive care unit, to help patients transition smoothly
from their operation to their recovery.
The perfusionists continually research new perfusion techniques to maintain this aspect of the program at the cutting edge. This is validated at national meetings where our group is often ahead of the rest of the country in innovation and the technology they are using. But the human factor is just as important as the technology, says Frank Scholl, MD, Chief of Pediatric Cardiac Surgery.
“Our perfusionists care deeply about our patients,” he says. “They are completely committed to the safety of our patients and understand the importance of their role in the team to ensure a successful operation. I feel fortunate to work with such dedicated individuals.”
