A look at: Perfusionists

Perfusionists Tim Dutton and Roberta Ward operate the heart-lung machine during open-heart surgery.
Perfusionists Tim Dutton and Roberta Ward operate the heart-lung machine during open-heart surgery.

They stand in for the heart and lungs during cardiac surgeries. During liver transplants, they re-route blood around the transplant area so surgeons can work. They are the ultimate recyclers: operating equipment that collects and cleans blood lost during certain surgical procedures and returns it to the patient.

Regardless of which specialized service they're providing, perfusionists are an integral part of the care teams that keep patients alive during some of the most complex procedures and treatments.

Of the approximately 50 perfusionists in Connecticut, Yale-New Haven Hospital employs 22. They care for neonatal, pediatric and adult patients at YNHH's York Street and Saint Raphael campuses and Bridgeport Hospital and provide services at VA hospital in West Haven.

Perfusionists most frequently assist with cardiac procedures in which surgeons temporarily stop the heart to keep it still. Perfusionists operate a heart-lung machine that diverts blood from the heart and lungs, adds oxygen, then returns the blood to the body. At the same time, they regulate blood gases and monitor circulation and other functions.

"No case is routine; each patient has different issues," said Roberta Ward, who has worked at YNHH 22 of her 30 years as a perfusionist. "Not only are you providing perfusion to your patient and anticipating the unexpected, you may be supervising and teaching a Quinnipiac University perfusion student. It becomes a balancing act, and can be very demanding."

Most of the time perfusionists work during scheduled surgeries, but they are on call for emergencies and provide 24/7 coverage for extracorporeal membrane oxygenation (ECMO) therapy. During ECMO, perfusionists operate equipment that keeps oxygenated blood circulating for several days to weeks, until the patient's heart or lungs have time to recover. Perfusionists also help place and manage ventricular assist devices, (VADs), surgically implanted mechanical pumps that do a weakened heart's work.

With a relatively small staff and such varied duties, YNHH's perfusionists must work together and collaborate with other care team members, said Ed Rocco, perfusion manager.

"We have a strong team mentality, because you never know when a colleague will need help," he said. "It's a challenging profession, but it's rewarding. There's a sense of accomplishment every time you assist in a procedure and help make a patient better."