What is a Perfusionist / Clinical Perfusion Scientist ?
During an open-heart operation, the department's heart-lung machines sustain the patient's life by taking over the functions of both the heart and lungs. This requires the use of artificial blood pumps, whilst the cardiac surgeon performs the operation. The process is known as “cardiopulmonary bypass” (CPB). CPB requires the use of a sterile tubing circuit that is connected to various artificial organs: Heart (blood pump); lungs (oxygenator; kidneys (haemodialysis). This occurs outside the body, and is thus known as Extra-Corporeal Circulation, (ECC).
Perfusionists, sometimes referred to as ‘heart lung technicians’, though now called ‘Clinical Perfusion Scientists’ in the UK, using a sterile technique, set up, and operate the heart-lung machine, ECC, and other specialised equipment that are used in the operating theatre during the operation, and in the Cardiac Intensive Care Unit and Coronary Care Unit both pre and post operatively.
All Perfusion Scientists at Morriston Hospital, (ABMU), are registered with The College of Clinical Perfusion Scientists of Great Britain and Ireland, and qualified members are accredited with The Society of Clinical Perfusion Scientists of Great Britain and Ireland.
Whist in theatre, and performing cardiopulmonary bypass, Perfusion Scientists, directed by the surgeon and anaesthetist, are responsible for regulating the patient's levels of oxygen and carbon dioxide; for measuring selected laboratory values such as red blood cell count; and for monitoring the patient’s circulation. Perfusion Scientists may also administer anaesthetic or other pharmaceutical agents through the cardiopulmonary bypass circuit. Other duties include the use of cell salvage equipment to minimise the use of donated blood, and support devices for the heart, including Intra Aortic Balloon Pumps, (IABP), and Ventricular Assist Devices, (VAD).
Perfusion Scientists therefore undergo rigorous training both academically, and practically, in order to thoroughly understand the body's circulatory system and to operate complex equipment that is used. Science graduates are employed who go on to further study to Masters level before being able to qualify and work as an independent practitioner. PhD level of education is becoming more common as the profession strives to maintain consistently high levels of educational standards.
Equipment / Clinical Work
The department holds at present, four MAQUET HLM 20 heart lung machines, Morriston being one of the first units in the UK to use such devices. We are the only hospital using a fully integrated datacapture system from MAQUET running over a wireless computer network.
In addition there are three MAQUET HCU 30 heater cooler units. For long-term perfusion, the MAQUET rotaflow system is used.
Pre and postoperative support, and invasive cardiology support, is maintained using the DATASCOPE 98XT, CS100 and CS300 Intra Aortic Balloon Pumps, with some 130 insertions in 2011. The department holds seven at present.
As well as the clinical responsibilities, the department is also accountable for the prosthetic heart valve stock for the centre.