The new role of the perfusionist in adult extracorporeal life support.
Adult and pediatric extracorporeal life support (ECLS) has been transformed by the European(1) and Australian( 2) experiences with a reduction of the circuit to its most basic form (Figure 1). Many factors have converged at this point in time to allow us to offer this support. The availability in the U.S.A. of an advanced oxygenator (Quadrox(D)) (Maquet Inc., Bridgewater, NJ), long-term centrifugal pumps and circuit coatings offers us the means to provide ECLS. The other equally important factor is the intensivist trained in extracorporeal therapies. Once the intensive care unit registered nurse (ICU RN) is trained to safely and effectively manage both the patient and ECLS circuit, this support may be offered. The perfusionist is in an unique position to educate and mentor the ICU RN in ECLS. There is, perhaps, no one in a better position to explain this equipment and its uses in an interdisciplinary-oriented pediatric and adult ECLS program than a perfusionist.
McCoach
Robert M
RM
Heart and Vascular Institute, Penn State's Milton S. Hershey Medical Center, Hershey, Pennsylvania 17003, USA. rmccoach@hmc.psu.edu
Baer
Larry D
LD
Wise
Robert K
RK
Woitas
Karl R
KR
Palanzo
David A
DA
Pae
Walter E
WE
El Banayosy
Aly
A
D000328:Adult; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000451:nursing / Q000639:trends; D002648:Child; D003422:Critical Care; D016638:Critical Illness; D006801:Humans; D008020:Life Support Care / Q000639:trends; D008511:Medicine / Q000639:trends*; D008611:Mentors; D010106:Oxygenators / Q000639:trends*; D010348:Patient Care Team; D013041:Specialties, Nursing / Q000193:education / Q000639:trends*