According to Eelco van Es, the role as a perfusionist is a ‘profession in development’. “But perfusionists are pivots within heart surgery. Without us, major parts of surgeries cannot be performed.” In the future, there will be a stronger demand for perfusionists, says Eelco.
‘A pivot in heart surgery’. What exactly does a perfusionist do?
“Simply put: I stop the heart from beating during an open heart procedure. Operating on a non-beating heart is easier. Once the patient is sedated, I build up the blood circulation as subtlety as possible. I then use a machine as a substitute for heart and lung functions. If all parameters are up to par, we put a stop to the heartbeat by injecting a substance with a high concentrated doses of potassium. After the procedure, I can let the heart take over its usual function.
How is it that people are so unfamiliar with a perfusionist’s’ work?
“It is a profession that is still in development and is still not a major field of expertise. In the Netherlands, there are only about 130 perfusionists, even though a large sum of heart surgeries cannot be performed without our help. There will be a stronger demand for perfusionists in the future, but as of this moment, the market is not making these demands and the field of medical science unfortunately does not consult our technical knowledge enough yet.”
Do you only work in the operating room, or do you also converse with patients?
“Ten years ago, I practically never saw patients outside of the operating room. But because of the implementation of a simplified heart-lung-machine, a so called ECMO, I get to spend more time with patients on the Intensive Care Unit. Nowadays, I visit patients on the ICU almost daily and engage more with patients and their families. But that also makes my work harder. As a perfusionists, you have to view the body from a very technical perspective, and that means you have to be able to look beyond your personal attachment to a patient.”
What other traits do you utilize in your profession?
“As a perfusionists you work independently and alone, so you have to be able to work like that. At the same time, I want to be a reliable co-worker and so I have to be able to admit to my mistakes. In addition, the work of a perfusionist has to be very accurate. You want to deliver the parameters as good as possible. But sometimes you have to ease up on perfectionism to learn how to deal with your responsibilities.”
How has the profession changed in the past twenty years?
“Procedures have gotten increasingly more complex, because we do a lot more re-operations; people live longer and return for procedures later in their life, and you have to be aware of that. Our discipline continues to develop. For instance, nowadays we work with artificial lungs for longer periods of time. But oncological procedures also demand our expertise a lot more than they used to. Thus, following training courses and visiting symposia is essential to remain good at what you do.”