In every cardiac surgery picture that you see anywhere in the media, at the edge of the picture there will be a big machine present connected to a container and tubes with blood in them; Right behind that behind the bloody equipment is a perfusionist, handling all the functions of blood and keeping the person lying on the operating table alive.

Perfusionists around the world are trained to be experts in extracorporeal technology, cardiopulmonary bypass, the intra-aortic balloon pump, the cell salvage machines and even salvaging donor organs for transplants. Yet, most commonly perfusionists get mistaken for perfumery experts or engineers. Frustrating as it is to explain to almost 90% of the people they end up meeting, perfusionists are blood experts as a whole.

How is a Perfusionist a blood expert?

Blood has a few functions; Those need to be maintained for the sustenance of life. If any of these functions lose their balance, the human body ends up in a state of mess. No one wants that right.

During cardiac surgery, when cardiopulmonary bypass is equipped a perfusionist continuously drains the deoxygenated blood from the right side of the heart, nourishes it with oxygen, medicates it as required, cleans it to remove trashy substances and pumps it back into the arterial system of the body. In the google definition of a perfusionist, they are described to replace the function of the heart and lungs using the heart-lung machine, but the technology is in-fact used to replace the function of the heart, lungs, kidneys and sometimes even the liver.

Is oxygen the most vital thing for survival? Yes. The transport of oxygen is of utmost importance to living human cells especially in the headquarters of the human body i.e. the brain. Blood acts as the highway for oxygen to get to its destination, while hemoglobin is the uber cab that can carry only 4 oxygens at a time. Perfusionists make sure oxygen gets a ride and the highway isn’t closed or jammed with traffic, so that oxygen reaches the cells in the most efficient way possible.

Apart from cardiopulmonary bypass, perfusionists take an active role in maintaining and monitoring intra-aortic balloon pumps and ensure the patients benefit from the assist devices as best as possible. On the other hand, perfusionists setting up and monitoring cell salvage devices or cell savers during numerous procedures do actually keep an eye on the purity of the red blood cells that are getting collected. This is an undeniable hint towards the fact that perfusionists do not let even a drop of blood go to waste, and when it does happen even if it is one of the most honest of mistakes, the guilt doesn’t let them sleep at night.

Sleepless nights, countless hours spent seated and staring into the reservoir during cardiac surgeries; bending down and standing up repeatedly while setting up the heart–lung machine; moving from one operating theatre to another to ensure the cell saver functions flawlessly; rushing from the operating room to the ICU to check on the IABP and ECMO machines; and at times standing vigil beside an ECMO patient for 12 hours or more—whether the sun filters through hospital windows or the stars shimmer in the night—hoping, always, that the patient makes it through. Unseen by patients and their families, a perfusionist wakes up every day to care for lives, directly and indirectly, with unwavering dedication.