Perfusion is the process where fluids such as blood and lymph pass through tissue in the body. A perfusionist is a trained professional who helps operate machinery when this process requires assistance, for example, during heart surgery.
A perfusionist works alongside the surgical team to care for people undergoing a heart procedure or those with critical illnesses requiring extracorporeal membrane oxygenation (ECMO).
Perfusionists operate equipment that externally and temporarily replaces or assists the heart and lungs. A heart-lung machine allows a person to survive heart surgery that requires the heart to stop, while ECMO assists the heart and lungs when serious illness affects them.
Read on to learn more about what a perfusionist does.
Perfusionists are not medical doctors. However, they work with doctors to protect a person’s health during surgery and other medical procedures.
Typically, perfusionists are responsible for operating extracorporeal circulation machines. These machines work by substituting the actions of the heart and lungs during medical procedures or critical illness.
Cardiovascular perfusionists usually work in the operating room. They may also care for people in the cardiovascular intensive care unit (ICU) or work in heart catheterization labs.
A perfusionist needs the following:
- a bachelor’s degree, usually in a scientific field such as biology
- certification from an accredited perfusion technology or extracorporeal technology program
- certification from the American Board of Cardiovascular Perfusion to be a certified clinical perfusionist
This process usually takes 4–6 years. A perfusionist will also need to meet state continuing education requirements that may include attending seminars or classes.
The heart and lungs work together to add oxygen to the blood, then pump the blood throughout the body. If one or both organs stop working, a person dies almost immediately.
However, a doctor
Perfusionists have the following responsibilities relating to the operation of the heart-lung machine:
- ensuring the machine is working correctly
- making sure the right parts are available
- ensuring a person remains stable while they are linked to the machine
The perfusionist monitors a person’s vitals, which includes maintaining normal blood flow, body temperature, and other signs.
Along with doctors, they implement a plan to prevent blood clots and bleeding.
When is a heart-lung machine necessary?
Some surgeries where this machine is necessary include:
- heart transplants
- lung transplants
- heart bypass surgery
Occasionally, a heart-lung machine may keep a person alive in an emergency or while awaiting surgery. For example, some infections may damage the heart. The heart-lung machine can help the heart rest as the person recovers from the infection.
When is an ECMO machine necessary?
The ECMO machine can also replace the function of the lungs and heart. It is a life-support machine.
People who require ECMO typically receive care in ICU.
Perfusionists can adjust the machine’s settings depending on a person’s condition. Typically, people may require ECMO support until the healthcare team treats the underlying problem.
Doctors may recommend ECMO if:
- a person is critically ill
- the lungs are unable to function adequately, for example, they are unable to provide enough oxygen to the body
- the heart is unable to pump blood around the body
- a person has heart or lung disease and is awaiting a transplant
There are two types of ECMO therapy. Doctors recommend venoarterial ECMO for problems with the heart and lungs and venovenous ECMO for lung problems only.
Perfusionists primarily support people during open heart surgery or when ECMO is necessary. They are not doctors, so they do not work alone or make treatment decisions.
Instead, perfusionists work with a person’s medical team to determine the best equipment for them, then ensure that the equipment works optimally.
Some of their other responsibilities include:
- explaining the perfusion process
- assessing the person’s medical history and determining the right equipment to use
- monitoring the person’s vital signs
- under the guidance of the surgeon, providing medications through the bypass circuit
- performing laboratory examinations, for example, on blood
- administration tasks, for example, purchasing and managing supply inventory
- communicating with other members of the team about the person’s care
Perfusionists may work with people on an ongoing basis, for example, when the person requires ECMO while critically ill or awaiting a heart transplant.
Many other surgical team members will tend to the person during heart surgery. The number of people and their specific roles may vary. In general, the team includes:
- a cardiovascular surgeon
- assisting surgeons
- cardiovascular nurses
- at least one anesthesiologist, who administers the anesthesia
- surgical technicians, who may help with gathering equipment or monitoring the person
When a person needs a heart-lung machine in ICU, they may have additional people on their team, such as a transplant coordinator, social worker, ICU nurse, or doctor specializing in critical care.
If anyone has concerns or questions about their heart surgery or the heart-lung machine, the first point of contact is the surgeon or intensive care physician in charge of their care.
Perfusionists play a vital role in supporting people in cardiovascular operating rooms and those receiving ECMO in the critical care unit.
They help to manage a person’s vital signs when their heart is stopped for surgery or the person’s heart and lungs are weak due to critical illness.
A person undergoing heart surgery may find it helpful to talk with a perfusionist about how the machines work and how the surgery will help protect their heart.