A Comprehensive Guide to Perfusion

Perfusionists genuinely are the heart of the operation. Hospitals must meet the needs of 340,000 patients who require open-heart surgery every year. 

What is a Perfusionist?

A perfusionist is a highly trained healthcare professional who operates a heart-lung machine during cardiac surgery. This machine serves as an artificial blood pump during the operation. Perfusionists are essential during these procedures as they help tend to the patient’s needs while the surgeon operates. They are required to remain in constant communication with the surgeon on the patient’s condition. If there are complications during the procedure that may compromise their health and safety, the perfusionist is responsible for stabilizing the patient with the necessary action given by the surgeon. Before any surgery, perfusionists must attend a briefing with the rest of the medical team that details the procedure. Following, they prepare the heart-lung machine and gather any other equipment needed to perform the necessary functions.

History of Perfusion

There have been many notable contributions that led to perfusion’s current success in today’s medical practice. 

Mid-18th Century 

The 1800s marked the early stages of perfusion. During this time, bubble oxygenation was invented, and a closed-circuit system for perfusion was developed. In 1858, evidence found that perfusion caused brief responsiveness in the arms of deceased patients.  

Mid-20th Century 

Advancements in perfusion led to the creation of a heart-lung machine. These machines allowed for successful surgeries on humans after experimenting with animals. The 1950s marked the first cardiopulmonary bypass surgery.

Throughout the 1960s, developments in the heart-lung machine allowed perfusion for more extended periods, leading to the bubble oxygenator’s creation in the 1970s. It became the standard of practice until the membrane oxygenator in the 1990s replaced it. 

The 21st Century and Beyond 

Refinements are still being made to perfusion devices and techniques today. Additionally, innovations have yielded positive results that could save thousands of lives every year. 

Perfusion in Practice

There are three different types of perfusion: cardiopulmonary bypass, extracorporeal membrane oxygenation, and isolated limb perfusion. When perfusion services are performed, there are necessary steps taken across all areas, including:

  • Pre-operative equipment inspection 
  • Circuit setup and prime 
  • Ancillary support 
  • Communications 
  • Intra-operative initiation of emergency bypass 
  • Post-operative 
  • Reporting and continuous improvement

Education and Certification 

There are seventeen accredited perfusion programs in the United States. A bachelor’s degree is required to enroll in any program, which includes two years of classroom studies accompanied by hands-on clinical training. After you complete a perfusion program, you can work until you obtain your certification. Some states require a license to practice, while others do not. 

To obtain your perfusion certification, you must complete a minimum of seventy-five assisted CPD procedures at an accredited academic medical center followed by two board exams. Once you pass the second board exam, you can become a certified clinical perfusionist (CCF). If you complete an additional forty independent CPB procedures, you’re eligible to forego the second exam.

Staffing Trends 

  • There are 3,989 certified perfusionists 
  • Approximately 44.3% of the workforce are older than 50 years 
  • Over 300 people leave the workforce every year 
  • There are approximately 200 new graduates every year
  • There is a current perfusionist shortage of nearly 100 clinicians

Advocating for Perfusion

It is important to bring awareness to perfusion as a vital medical service and an excellent career choice. Perfusionists play an essential role in today’s medical practice. Their extraordinary contributions provide valuable assistance and save thousands of lives every year.