Perfusionist


A perfusionist, also known as a clinical perfusionist or a cardiovascular perfusionist, is a specialized healthcare professional who uses the heart-lung machine during cardiac surgery and other surgeries that require cardiopulmonary bypass to manage the patient's physiological status. The perfusionist is a highly trained member of the cardiothoracic surgical team which consists of cardiac surgeons, anesthesiologists, physician assistants, surgical technologists, and nurses. The perfusionist's main responsibility is to manage the physiological and metabolic needs of the cardiac surgical patient so that the cardiac surgeon may operate on a still, unbeating heart. This is accomplished through the utilization of the heart-lung machine, as well as its associated components of an oxygenator, filters, reservoirs and tubing. The perfusionist is solely responsible for the management of circulatory and respiratory functions of the patient which has a great effect on the patient systemic condition and allows the cardiac surgeon to focus on the actual surgical procedure and less on the immediate needs of the patient. Other responsibilities include autologous blood collection and processing, implementation and management of the intra-aortic balloon pump, adult and infant extracorporeal membrane oxygenation (ECMO) as well as monitoring of anticoagulation, electrolyte, acid-base balance and blood-gas composition. In many tertiary hospitals, perfusionists are also key personnel in placing and managing patients on ventricular assist devices as bridge to recovery or heart transplantation and supporting patients receiving lung or liver transplants. In certain hospitals, perfusionists can be involved in procurement of cardiothoracic donor organs

for transplantation. In the United States, a bachelor's degree or junior-level prerequisites with concentrations in biology, chemistry, anatomy and physiology are required to be admitted to a perfusion program. As of 2012, there were 17 perfusion training programs in the United States. Training typically consists of two years of academic and clinical education. Although the structure and training philosophies of perfusion programs differ, typically a perfusion student will begin their training in a didactic fashion in which the student will closely follow instructions from certified clinical perfusionist in the confines of a cardiac surgery procedures . Academic coursework may be concurrent or precede this didactic clinical instruction and is equally vital for their training. Early in their clinical training, the perfusion student may have little involvement in the cardiac surgical procedure outside of an observational role. However, as time progresses, more tasks may be incrementally delegated to the perfusion student. These added responsibilities in the clinical environment are delegated to the perfusion student, with the ultimate goal of producing a capable and competent perfusion student. Once a perfusion student graduates from a perfusion program, he or she is not a certified clinical perfusionist but must begin the certification process. In the interim, the perfusion graduate is typically referred to as board-eligible, which is sufficient for employment in cardiac surgery with the understanding that advancing their status to a certified clinical perfusionist is required for long-term employment. Most hospitals or perfusion employers have stipulations on the duration of board-eligible status for an employed perfusionist.