Perfusion is the technique that maintains the circulation of oxygenated blood throughout the body when the heart and lungs are stopped during surgery. It is carried out by the perfusionist, who operates the cardiopulmonary bypass (CPB) machine and life-support systems such as ECMO to keep the organs alive while the surgeon operates on the heart.
Without perfusion, modern cardiac surgery would not exist. It is a discipline that combines physiology, engineering and real-time clinical decision-making. In this guide we summarize what it is, who performs it and how it relates to the techniques and equipment that make it possible.
What perfusion actually does
During an open-heart operation, the surgeon needs a still, bloodless heart. The cardiopulmonary bypass machine takes over two of the body's vital functions:
- Pumping the blood throughout the body, replacing the heart.
- Oxygenating it and removing CO₂ through an oxygenator, replacing the lungs.
The perfusionist continuously monitors and adjusts flow, pressure, temperature, blood gases and anticoagulation. You can learn more about how this professional trains and about the machines and brands they use.
CPB and ECMO: two faces of perfusion
Cardiopulmonary bypass (CPB)
Temporary use in the operating room during cardiac surgery. It lasts for the duration of the procedure.
ECMO
Prolonged life support for critically ill patients with cardiac or respiratory failure; it can last days or weeks. More about ECMO →
Why it matters
Perfusion is one of the most critical and, at the same time, least known healthcare professions in the operating room. Every decision the perfusionist makes has immediate consequences for organ oxygenation. That is why safety rests on international guidelines and the clinical best practices we publish on the blog.
Frequently asked questions
What is perfusion?
The technique of maintaining the circulation of oxygenated blood through the body when the heart and lungs are stopped during surgery, using the cardiopulmonary bypass machine.
Who performs perfusion?
The perfusionist, a highly specialized healthcare professional who operates the heart-lung machine and ECMO systems.
What is the difference between CPB and ECMO?
CPB is used temporarily during cardiac surgery; ECMO is prolonged support for critically ill patients that can last days or weeks.