Perfusionists are highly trained members of the Cardiac Center at Children’s Hospital of Philadelphia (CHOP). Part of the cardiac surgical team, perfusionists play a critical role in any procedure where a patient’s circulatory or respiratory system needs to be supported.
A perfusionist’s main job is to operate the heart-lung machine (blood pump) during cardiac surgery. A surgeon needs a patient’s heart to be still in order to perform repairs, but the patient’s body is still dependent on oxygenated blood to keep their organs alive and healthy. The perfusionist uses the heart-lung machine to assume the role of the patient’s heart and lungs — from outside of their body.
In addition to managing the heart-lung machine, a perfusionist holds many other important roles, including the support of patients that require ventricular assist devices (VADs), extracorporeal membrane oxygenation (ECMO), blood conservation and research. For patients in ongoing heart or respiratory failure, perfusionists manage VADs or ECMO systems, which can completely support the heart and lungs for days or even months. This gives critically ill children an opportunity to heal and overcome life-threatening illnesses.
We sat down with the CHOP perfusion team to learn more about their invaluable role in the Cardiac Center.
Q: How much do perfusionists interact with patients and families?
A: Perfusion is a very interesting, unique field, but many people don’t know we exist! In many ways, we are almost a secret entity of the cardiac operating room. Our heart-lung machine comes into action after the patient is asleep, and we come off bypass before the patient wakes up from their procedure. Many times, patients don’t even know we were there! For patients who require additional support outside of the operating room — such as a VAD or ECMO — we help manage and troubleshoot these devices, and we enjoy our interactions with patients and families during that time.
Q: What is the most rewarding part of your job?
A: One of the most rewarding parts of being a perfusionist is witnessing patients go from the sickest they have ever been to having a new chance at life. For patients in heart failure who need a ventricular assist device, perfusionists are involved with the implantation of the device as well as device management throughout the wait for a donor heart.
During the heart transplant, we run the heart-lung machine. There is a time during that procedure when the sick heart comes out, and the patient’s chest is empty. The perfusionist running the heart-lung machine is completely supporting the patient’s circulation — this is the ultimate demonstration of our role.
As the patient progresses in their recovery, it is so rewarding to know that we're there, supporting them, through the most difficult part of their journey.
Q: What current research projects does your team have underway?
A: Our department is very focused on quality improvement, so the majority of our studies are focused on ways to improve the care we give our patients. We also perform several clinical evaluation and novel research projects each year. Our research has been recognized by several well-respected medical journals, and our department has represented CHOP at medical conferences around the world. Some recent projects include:
- Evaluating which blood management techniques and equipment will lessen patient exposure to donor blood
- Studying cardiopulmonary bypass techniques and how they might influence the development of post-operative acute kidney injury
In addition to clinical research, we are also involved in animal studies investigating factors that play a significant role in cases requiring cardiopulmonary bypass and ECMO and evaluating their neurological impact.
Q: What should CHOP patients and families know about the perfusion team?
A: Even though you may not see us, the CHOP perfusion team is here for you and your family. Whether it’s an elective cardiac procedure or an emergent resuscitation in the Cardiac Intensive Care Unit (CICU), we are here to support your family during that critical time. We are a dedicated team with state-of-the-art equipment. We pride ourselves on being active members of perfusion professional societies, and we regularly evaluate the latest scientific literature to ensure our care is cutting edge. Our efforts, along with those of our Cardiac Center team members’, are focused on one goal: providing the best possible outcome for every child we treat.