More Than Turning Knobs: The Expanding Role of the Clinical Perfusionist

Abstract

The practice of clinical cardiovascular perfusion has experienced major changes in scope since its inception over thirty years ago. The tasks of today's clinical perfusionist may include not only the usual life support of patients undergoing cardiac surgery, but also such diverse duties as IABP therapy, VAD life support, artificial heart management, blood salvage for autotransfusion, rapid fluid administration, ECMO therapy, liver transplantation, circulatory support for cardiac arrest, and perfusion for distant heart-lung procurement for transplantation. All of these duties are practiced by the perfusion team of the Johns Hopkins Medical Institutions. Except for the normal surgical tasks of a perfusion- 1st, these tasks have been assumed by the perfusion team over a recent three year period with no increase in staff. Certain managerial and team strategies were necessary to achieve this without sacrificing either patient safety or staff morale.