For every ACTION, there is an EQUAL and OPPOSITE REACTION. This theory impacts life’s varied circumstances, the CAUSE and EFFECT implication…
Author / Editor:
Co-Editor Anna Lou Villena 🙂
From the cascade of events, I found myself in a retrospective mood and thought about the fundamentals of science which I learned during primary years- The Newton’s Law of Motion: That for every ACTION, there is an EQUAL and OPPOSITE REACTION. This theory impacts life’s varied circumstances, the CAUSE and EFFECT implication and even in conjunction to a Perfusionist’s knowledge when handling the Intra- Aortic Balloon Pump (IABP) – TRIGGER MODES and EVENTS in order to create an optimum timing for the inflation and deflation.
RETROGRADING our SCOPE
As Clinical or Cardiovascular Perfusionist, we handle more or less 5 consoles and designate which is the main pump (HEART) and the rest auxiliary consoles for cardioplegia, suckers and vent. In analogy, our scope of practice is not just rutted on the MAIN PUMP – to manage the physiological and metabolic needs of the cardiac surgical patient so that the cardiac surgeon may operate on a still, arrested heart. However, in a peripheral view, we are also responsible in the following aspects:
- Implementation and management of IABP
- Autologous blood collection and processing
- Adult and infant Extracorporeal Membrane Oxygenation (ECMO)
- Monitoring of anticoagulation, electrolyte, acid-base balance and blood gas composition during the procedure
- Key personnel in planning and managing patients on Ventricular Assist Device (VAD) as bridge to recovery or heart transplantation
- Supporting patients receiving lung or liver transplantation
- Others may be involved in procurement of Cardiothoracic donor organs for transplantation
THE MAIN PIPELINE
Obviously the mainstream is the one highlighted from the concept of the perfusionist’s scope of practice. So this leads me now in identifying the TRIGGER EVENTS, the CAUSE, the ACTION that in effect gave me an impulse to continue sharing an educational discussion given by Dr. Georg Wieselthaler, director of the Heart Transplant and Mechanical Circulatory Support Program at the University of San Francisco Heart and Vascular Center.
During our summer workshop, that was held a month ago, he talked about the State of the Art of Treatment of the Failing Heart and I was all the more fascinated with a vision that with our future technology, the perfusionist’s scope of practice will in parallel become more SOPHISTICATED and DEMANDING with regards to handling and assisting complicated devices. But, on the extreme side of my fascination, there was an apprehension because honestly my experience in the perfusion field is not as vast as others in the international arena ,which for them, VADs and ECMOs are just one of their ordinary “Perfusion toys”. However, as I said there are TRIGGER EVENTS that made me pulled through and opted to deliver it in an amateur level of disseminating an interesting topic.
TRIGGER EVENTS and SPRINGBOARD
The KINETIC impulse was ignited when I traced the root of my emotion of how proud I am to belong in this kind of profession and how prouder I felt for my fellow colleagues who have been in this field for several years and rightly become the epitome in the “oxygenator and circuit world” and maybe not too far, I will also cross this intersection of experiencing a more challenging battlefield of machines and devices.
On the other hand, the turning point was Mr. Frank Aprile’s posts last Wednesday (June 26, 2013) and Thursday (June 27, 2013). An article entitled the Heart Surgery in America 8.0 and 9.0. His encounter with Joshua “aka” LVADone was a mere coincidence, but it gained a positive reaction on my personal note. I would say, an inspiration from Joshua’s perspective and optimistic view that as LVADers, they are test pilots, and with the progression in the medical industry, he is hopeful that artificial heart would replace heart transplantation since it is known that TITANIUM doesn’t have a rejection factor. Perhaps, Joshua’s drive, he said was more of a battle cry to help others get through what he had already experienced. Ironically for me, even if I still don’t have the actual encounter with this kind of device, but my drive of sharing an educational POWERPOINT Presentation showing the Evolution and Future Technology of VADs from a dedicated specialist, creates a feeling of FULFILLMENT.
AGITATING a GRIDLOCKED Mind
Ventricular Assist Devices (VADs) are mechanical heart assist pumps which could serve as:
- Bridge to heart transplantation – prolong a patient’s life while waiting for a heart transplant, or
- Destination therapy – improving quality life for end stage heart failure patients who do not qualify for a heart transplant.
Principle: A pump that assists the heart by pumping blood to the body. It aids the failing ventricle by taking some of the work load from the heart.
Mechanism and Components:
- SURGEON : Connects the pump to the heart by using a tube that is specifically made for this purpose.
- FLOW: Blood Heart Inflow tube VAD Outflow tube Major Blood Vessels
- PUMP : placed in upper abdomen and cannot be seen
- COMPUTER for the PUMP : outside the body and can be worn with a fanny pack or a belt clip
- SMALL CORD: connecting the Pump and Computer that exits the body via a small opening on the side of the abdomen
- Battery / AC Power Adapter: powering the system in order for the patient to resume most daily living activities.
Indeed, a basic know-how of this life saving device compasses us to our Future DESTINATION in the Perfusion arena.
The full PowerPoint presentation on VADs will follow with the next post 🙂