Perfusionist explains the heart-lung machine for cardiac surgery

Рет қаралды 72,826

Max Feinstein

Күн бұрын

Пікірлер: 130

@Nunofurdambiznez 5 ай бұрын

Don't you DARE stop making these videos!! Your videos are among the VERY FEW that I can understand right off the bat!

@stevehornett4896 5 ай бұрын

Amen!

@antsgamingvideosn2b 5 ай бұрын

Amen! ❤

@austinsteinour5052 5 ай бұрын

Perfusion is an awesome healthcare career that is definitely under-rated. Thank you for highlighting this lesser known field.

@mekkler 4 ай бұрын

And I never heard of it before now.

@tylervalentine6401 5 ай бұрын

I have never seen someone who is so dedicated to making such informative and entertaining KZbin videos as well as having a full time career! It is truly a great day when I see the notification that you posted a new KZbin video. Thank you for all the awesome videos and content!

@alptekinakturk4185 5 ай бұрын

The level of quality in this video is mind blowing.

@apawstate 5 ай бұрын

I had a valve repair surgery years ago. Amazing to see what they did to keep me alive while the surgeon worked!

@emeksb4823 5 ай бұрын

Perfusionist do a lot. The first day I heard of this career I was amazed. The whole team in the OR are incredible in ensuring the safety of the patient.

@matthewwelters6397 5 ай бұрын

Caleb! Awesome perfusionist! Nice of him to tell us some of his insights.

@mollysullivan6414 5 ай бұрын

omg not perfusion summarizing 4 years of anesthesia residency in the last ten seconds LOL

@scrumptious9673 5 ай бұрын

Savage 😂 loved Caleb’s sense of humour

@distanndreart1344 Ай бұрын

@@scrumptious9673 Hello, I have been suffering from severe sinusitis for exactly 30 years. I am Brazilian, I am 45 years old and today they are treating me at the HC Hospital das Clínicas in São Paulo. I had a relapse because I had COVID and ended up with consequences, but with a lot of effort and prayers, today I am partially with limitations in my hands, I want to have better treatment for a better quality of life, and I know that in the United States everything is much more detailed and they give the best treatment in the world, I would like to know if you have any form of an exchange of treatment, as I have a dream of visiting the United States and taking part in the treatment of myasthenia gravis, I would really like to be able to go and get treatment there, could you tell me if there is any way for me to apply for a scholarship? study, oh please, I really want a better quality of life, I await your response and thank you

@ButterflyKissesHealing 5 ай бұрын

This is both fascinating and more complex than I ever imagined as a non medical individual. I am in awe at your level of expertise. Thank you both for dedicating your lives to improve the lives of others.

@acoker54 5 ай бұрын

Please don’t stop making videos. I enjoy and learn so much. I always wanted to be a CRNA but didn’t think I was smart enough.

@PPGATL 4 ай бұрын

In 1990 I went to work, in Germany, performing field service on Stöckert HLMs - I still have coffee cups from the S3 launch but actually started while both CAPS and the initial release version was still in the market. I was amazed to see how recognizable some of the equipment still is; the peristaltic pump heads, level and bubble detectors, heater/cooler, as well as the general shape and form of the machine is the same, colors and controls have obviously changed and improved. Sorry about those hand crank things though. My version only went into one roller, glad to see they are at least using two pins now. Definitely some very excellent machining and engineering in those machines. Strangely enough, I also recognize the disposables manufacturer because I am now employed by them. My role for a very long time has been in the cath lab but we have recently transitioned/ are transitioning to training on the cell savers and ACT machines. Fun stuff and thanks for the video and memories!

@dmorga1 5 ай бұрын

As always, what a well-done interview, Max. Caleb is obviously a very skilled perfusionist and good teacher, and your interview gave a broad and yet detailed sense of what the work is like.

@frankdonagher7279 5 ай бұрын

my wife loves your videos, she has learned alot from you She had open heart surgery 12 years ago

@edcasey9738 5 ай бұрын

Good job Max & Caleb!! Proud to work with you both.

@billwittman0504 2 ай бұрын

Having had heart surgery three months ago for a triple bypass and I'm now working doing the same thing I did before but feeling better doing it is a testimony to the surgical team and caregivers who worked on me. I'm 71yrs old, travel all the US and Canada as a field engineer who commissions equipment at water treatment facilities and find work to be very physical at times is a testimony. A big "THANK YOU" to the HEROS.

@keremcemayaz2795 4 ай бұрын

Such a complicated mechanism put together in a way everybody can understand. Just phenomenal!

@jordinh4 5 ай бұрын

Love your videos Max, I’m a certified perfusionist here in Brazil 🇧🇷. Thank you for showing a little bit of love to this awesome job in healthcare. 👏🏼👏🏼

@jrhalabamacustoms5673 4 ай бұрын

Always a pleasure to learn from you. Ive been teh patient that was absolutely helpless and my life was in the hands of the clinicians. As was said, its a job, but for the recipient its a life changing event.

@ReeceTheRipper 5 ай бұрын

I just finished my cardio thoracic surgery rotation, I wish this video came out before I started! Very educational, thanks Doc!

@scrumptious9673 5 ай бұрын

🎉

@shelleysflyingdreams 5 ай бұрын

It’s just amazing what can be done nowadays. Thanks for sharing this.

@codmn1824 4 ай бұрын

Give this man his money ASAP

@elisabetk2595 5 ай бұрын

When I had an extensive OHS last year, I think I was more afraid of being on bypass than of having the surgery itself. Since I'm one of those people who feel more calm and reassured when I know more about what is being done, I wish that this video had been available for me then. Thank you for doing this one!

@johnb4183 5 ай бұрын

Hello @elisabetk2595 Did you experience any post surgery cognitive changes after your heart surgery? Have you ever heard of the term "pump head" check it out I think you will find it interesting. Take care......!

@nickmorgan8434 5 ай бұрын

I was on Ecmo for 21 days..i saw crazy things

@ethanb3299 5 ай бұрын

I work as a clinical technician at a hospital and I walk past the perfusionists office often, always wondered exactly what it was that they do 🙌🏻

@ScBoyyx 4 ай бұрын

They usually play the drums!

@laurasnow7822 5 ай бұрын

This is so insane. For some reason this freaked me out.

@llamalance 5 ай бұрын

Really appreciate you taking the time to make this very informative video!

@danielmosley7893 4 ай бұрын

Wow! This guy is well trained and very knowledgeable. Thank you for all that you do the help save lives. Amazing!!

@Wav3Me 5 ай бұрын

Are you finally an official anesthesiologist?

@acf894 22 күн бұрын

This is a fantastic video, Quinnipiac trains excellent providers.

@DemDoolies 5 ай бұрын

Man your videos have me so excited to start medical school in a few weeks. Thanks for the great content

@sherrydawson6253 5 ай бұрын

OMG U HAVE THE MOST AMAZING VODEOS! So a perfusionist is not a doctor? From what all they need to know and do they should be. This was so interesting I bet there scared in the begining. He was so calm and informative. They must make great money. Imagine your 1 of only 5000¡ wow. Thank you both so much!! ❤❤❤❤❤❤

@CaptainApathetic 5 ай бұрын

Yea they're a very specialized role, one of the lesser known allied medical professionals. There's a lot more than just Doctors and Nurses.

@robertwilliam9558 5 ай бұрын

Max, very interesting topic. Thank You

@iaeeniaeen1898 5 ай бұрын

Awesome video! One question: if the bubble detector kills the pump, what happens next? Having the heart lung bypass machine shut down mid surgery doesn’t sound much better than an air embolus…

@ScBoyyx 4 ай бұрын

There are shunts in the arterial line where you can divert the bubbles back to the reservoir. If your bubble detector alarms and shuts off the pump, you clamp your lines distal to the recirculation shunt, and then you work the bubbles out, then go back on bypass. This can be done in a quick manner, and we usually cool patients on bypass, so they can handle intermittent periods of ischemia.

@agilegold 5 ай бұрын

Yay bonus reel! And chair comments. Excellent video.

@pilotmark2861 5 ай бұрын

Fantastic video. This machine is so hi tech compared to the machines I worked with 30 years ago !

@KyleGotSkill 26 күн бұрын

This was really inciteful to someone who got a heart transplant at 9 days old back in 1995. I was wondering what kind of redundancies are in place incase of failure of one of the pumps, good idea covering that but what happens during the failover event? Just a brief 30 second stop in flow while the manual pump is put in place? What kind of maintenance is given to this kind of machine since it has so many moving parts? How is this machine cleaned as well? Maybe some topics for a future video! Thanks Max!

@concealed4carry 5 ай бұрын

This video is great. I learned so much in the past 10 minutes. I had no idea this was a whole study in and of itself. Now I have a few questions. 1 Do not need to be a full board certified doctor for this?? Did I hear him right? Only a masters degree is needed? 2 who actually insert the canula into the patient him or the surgeon? 3 How in the world do you clean and sanitize that machine. I am guessing most of the tubing is discarded, but still, the machine still needs to be cleaned. That is a the video itself.

@ScBoyyx 4 ай бұрын

1. You do not need to be a medical doctor to run the heart lung machine. You need to be a Clinically Certified Perfusionist (CCP) who passes the American Board of Cardiovascular Perfusion (ABCP) board exam. Most of the perfusion training programs in the US are masters degrees, however there are still a handful of programs which are a post-baccalaureate certificates. 2. The surgeon places the cannulas, which is a highly technical skill. Perfusionist often advise the surgeon on which size cannulas to use for each patient, as we need to optimize the size for a targeted pressure and flow. There are many different types of cannulas and cannula placement strategies depending on the type of surgery. 3. Everything on the heart-lung machine that blood contacts is discarded after the surgery. Part of the job of a perfusionist is setting up the machine with new disposables prior to the surgery. This includes new tubing, reservoir, oxygenator, transducers, and more.

@Robby334 5 ай бұрын

Amazing we thank all medial staff in the world

@Respect_N55 4 ай бұрын

Such an informative video! What a knowledgeable Perfusionist as well Bravo brother!

@phyllojoe5346 5 ай бұрын

This was super interesting!

@nekajuii 5 ай бұрын

Super informative, please keep them ocming

@hawkeye454 5 ай бұрын

Those peristaltic pumps are pretty cool. I use a commercial version of them for transferring thick chemicals at work. Very different of course but similar design.

@javiTests 5 ай бұрын

Look how big that machine has to be in comparison to our lungs and heart... Our body is freaking amazing!! 😊

@GregSr 5 ай бұрын

Having had a triple bypass about 5 years ago, it was fun to watch this in my rear view mirror. I'm 70 now and my heart is running well. One issue I had right after surgery was with my memory and focus. For about a month I could not focus mentally nor could I rely on my memory. Because of that, I went through a period of depression. My regular doctor didn't offer a good explanation except to say that maybe I had "pump brain". He said sometimes the blood cells get changed in some way as they pass through the external pump. That leads to some strange effects in the brain which eventually clear up. Is there really such thing as "pump brain"?

@kinphillips3783 5 ай бұрын

Thank you for doing this video! I am going to Respiratory Therapy school, and then hopefully one day, I can get my master's in cardiovascular perfusion.

@danbrodsky57 5 ай бұрын

There is part of the procedure I have watched where the Cardiothoracic surgeon has to remove air from the line or could be dangerous to the brain. Talk about serious risks these medical professionals take to have their patients achieve better outcomes... Wondering one day if Robotics would help these type of procedures. Thanks for sharing !

@KirstinRN 5 ай бұрын

Very interesting, thanks for sharing! Great video!!

@OusmanReviews Ай бұрын

Thank you for the excellent video! I have a question that only a perfusionist can answer: How do you feel working as a perfusionist?

@HobbesBaxter 5 ай бұрын

Thanks Dr. Max!

@CoThG 5 ай бұрын

Outstanding video!

@maxim9376 5 ай бұрын

The hospital trusting Windows to the extend of their patients lives is crazy. Like imagine this piece of spy/ malware hits you with the unskippable update mid surgery...

@toplel1860 3 ай бұрын

Foreal lol stuff like that is genuinely scary to think about just imagine a blue screen mid surgery

@mtnairpilot 5 ай бұрын

How much blood is in the circuit? Does the heat lung machine have to be preloaded with fluid?

@ScBoyyx 4 ай бұрын

The heart lung machine needs to be primed with fluid prior to surgery to remove air from all the tubing, oxygenator, and other components. Plasmalyte is usually the fluid of choice. There are ways to reduce the amount of crystalloid in the circuit prior to going on bypass to reduce the amount of hemodilution (blood from the patient mixed with the priming solution). For most adult cases, the heart lung machine is primed with 1500 ml of fluid, and with some of the reduction strategies we can get that number down to 800-900 ml. For pediatric cases, the pump is commonly primed with red blood cells due to the ratio of patient blood to priming volume.

@darriontunstall3708 5 ай бұрын

Wow! That was very cool and amazing! I learned a lot! I really enjoy donating to the anesthesiologist foundation, since it was hard for me to go to college because of my cerebral palsy, I really wanted to be an anesthesiologist! Perfusionist are great too

@TeshagerGJM 20 күн бұрын

Simply thank you!

@naylani7790 5 ай бұрын

I just got my acceptance letter into a perfusion program last week!😭I’m scared as h3ll lol but very excited to enter this field✨

@pamgamble7506 4 ай бұрын

Good for you, good luck

@naylani7790 4 ай бұрын

@@pamgamble7506 Thank you! I appreciate that 😊

@scgraves98 3 ай бұрын

This makes me want to go back to school for perfusion

@jazzyboydc 5 ай бұрын

Do u need extra blood to be on a heart and lung machine? Because all the chambers of the heart and lung machine take up space. And I would think the body would be short on blood. I could be wrong.

@shane9209 4 ай бұрын

Great video Max! Thank you 🎉

@johno9507 4 ай бұрын

Be interesting to hear your views on 'pumphead' or Postperfusion syndrome.

@paulaneph3257 4 ай бұрын

Im a medical equipment planner. Very helpful video. I know the equipment but I don’t know how it works all of the time.

@Rickytikkitavi 5 ай бұрын

You sir earned yourself a subscription 👍🏽

@liam5487 5 ай бұрын

How does stopping the pump in event of an emergency help protect the patient? Wouldn't that be analogous to their heart stopping if they weren't on bypass?

@ShawnLangness 5 ай бұрын

What a smart and handsome perfusionist! Is he single? 😉🖤 great video guys!

@bermeter1671 5 ай бұрын

Thank you for the video;)

@netty10453 Ай бұрын

Is this the same as ECMO?

@idoben-yair429 5 ай бұрын

It sounds like the perfusionist is not an MD? Is that correct, or did he just leave out the med school part?

@AlexDumBanane 5 ай бұрын

Perfusionist usually have a Master degree and are not MDs.

@mmoo1954 5 ай бұрын

A perfusionist is not an MD, it is a separate program at the college level in Canada

@a4andrei 4 ай бұрын

How do you clean the machine?

@ScBoyyx 4 ай бұрын

Everything on the heart-lung machine that blood contacts is discarded after the surgery. Part of the job of a perfusionist is setting up the machine with new disposables prior to the surgery. This includes new tubing, reservoir, oxygenator, transducers, and more.

@kaneda1674 5 ай бұрын

Dude thank you for this. Coming from a CA-1

@BarryCo-p4c Ай бұрын

Good tutorial.

@spumonihusky 5 ай бұрын

What about keeping blood flowing through the lungs?

@bartoncourcier414 5 ай бұрын

I did a co-op in 1191 with Pfizer in Irvine where I worked on process validations for the cardiopulmonary product line. Cardiotomy reservoirs, and the Plexus hollow fiber oxygenator which was fairly new tech at the time. Most oxygenators on the market were membrane designs.

@charlenetrawick1647 5 ай бұрын

THIS is an amazing !

@johnb4183 5 ай бұрын

Max , have you ever heard the term "pump head " in regards to cabg and being on the " pump" ? Thanks !

@mateuszcielas3362 5 ай бұрын

so basically why ECMOs cant be used during surgeries as they are pretty similar things?

@ScBoyyx 4 ай бұрын

There are several aspects of the heart lung machine that make it better optimized for surgery. The main advantage is having a reservoir for blood to return to, this makes it easier to manage blood volume during surgery. The reservoir also allows for a place to return shed blood from the field via suckers and vents. We also need a pump for cardioplegia delivery.

@jenniferaustin6778 5 ай бұрын

Great video!!! 🙌🏻

@kgrfirdjy 5 ай бұрын

that looks similar to hemodialysis machines. i think those are fascinating.

@pattygq 2 ай бұрын

Excellent video. 15:18 Jesus they're running Windows 11 on that machine.

@FireRescue884 Ай бұрын

I’m going in for robotic bypass in 4 weeks, I’m pretty freaked out 😳

@colb9260 5 ай бұрын

Although cardiac surgery is done in my country. They only want doctors to be the perfusionist so the nurses with a doctorate in the field are never hired for that role/department.

@petrnechaev3290 3 ай бұрын

Outstanding!

@pamgamble7506 4 ай бұрын

How is all this cleaned after use?

@ScBoyyx 4 ай бұрын

@adriandeb2710 5 ай бұрын

Great video so interesting

@Dark_Helmet15 5 ай бұрын

making me want to back to school after finishing my Ph.D

@personincognito3989 15 күн бұрын

Doctor can you come to Vancouver to St Paul's hospital for a short or long term assignment? we need perfusionists very badly. ❤❤My surgery has been put off because we have none, please send this to all your friends. ***If I have to wait much longer I will go into heart failure. I also work in healthcare. We are desperate for doctors. Written Nov 14/24.

@zyncless 5 ай бұрын

cool stuff!

@DoctorWho14615 5 ай бұрын

So ECMO is nothing like ECTO, as in Ecto-Cooler.

@dr.stevenpennym.d.3241 5 ай бұрын

Bilateral pulmonary lobectomy

@azieladrian5571 3 ай бұрын

Hello bro thanks this video

@scrumptious9673 5 ай бұрын

Sooooo good

@MonishR96 3 ай бұрын

Interesting !

@jacksew 5 ай бұрын

i want to apply to perfusionist school :))

@newengland8126 5 ай бұрын

When an anesthesiologist broke my father's teeth, he did have a nurse give them to me in a jar. It was a $4000 bridge crown.

@josiahhorner6705 5 ай бұрын

Kuddos to people in this field because i couldn't do this!

@paulm4137 5 ай бұрын

So you have 4 years of Med School, and 3-4 years of Anesthesia residency with Board Certification soon to come (if not already). But the Perfusionist, with a 2 year masters degree, has control of the Anesthesia and Oxygen knobs on the equipment. I'm not belittling his ability or training, but what am I missing?