@@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
I have never seen someone who is so dedicated to making such informative and entertaining RUclips 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 RUclips video. Thank you for all the awesome videos and content!
I love that name of your channel. So, what do you call a service dog or cat who refuses to go to church with his or her owner? (The answer's right there!) I know it's corny, but I've had four Guide Dogs, and thankfully they all loved church.
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.
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.
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.
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.
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. 👏🏼👏🏼
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.
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!
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!
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......!
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!! ❤❤❤❤❤❤
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…
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.
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.
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.
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.
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.
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
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!
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.
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.
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"?
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 !
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...
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?
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.
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.
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.
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.
I have coronary artery disease and congestive heart failure. I take 11 pills per day. I wonder why they can't do a bypass on me and give me new arteries.
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.
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.
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?
Don't you DARE stop making these videos!! Your videos are among the VERY FEW that I can understand right off the bat!
Amen!
Amen! ❤
Perfusion is an awesome healthcare career that is definitely under-rated. Thank you for highlighting this lesser known field.
And I never heard of it before now.
omg not perfusion summarizing 4 years of anesthesia residency in the last ten seconds LOL
Savage 😂 loved Caleb’s sense of humour
@@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
I have never seen someone who is so dedicated to making such informative and entertaining RUclips 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 RUclips video. Thank you for all the awesome videos and content!
The level of quality in this video is mind blowing.
I had a valve repair surgery years ago. Amazing to see what they did to keep me alive while the surgeon worked!
I love that name of your channel. So, what do you call a service dog or cat who refuses to go to church with his or her owner?
(The answer's right there!)
I know it's corny, but I've had four Guide Dogs, and thankfully they all loved church.
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.
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.
Caleb! Awesome perfusionist! Nice of him to tell us some of his insights.
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.
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.
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.
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. 👏🏼👏🏼
Such a complicated mechanism put together in a way everybody can understand. Just phenomenal!
my wife loves your videos, she has learned alot from you She had open heart surgery 12 years ago
Good job Max & Caleb!! Proud to work with you both.
It’s just amazing what can be done nowadays. Thanks for sharing this.
I just finished my cardio thoracic surgery rotation, I wish this video came out before I started! Very educational, thanks Doc!
🎉
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.
Wow! This guy is well trained and very knowledgeable. Thank you for all that you do the help save lives. Amazing!!
I was on Ecmo for 21 days..i saw crazy things
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!
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 🙌🏻
They usually play the drums!
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!
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......!
Max, very interesting topic. Thank You
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!! ❤❤❤❤❤❤
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.
This is so insane. For some reason this freaked me out.
Give this man his money ASAP
Yay bonus reel! And chair comments. Excellent video.
Really appreciate you taking the time to make this very informative video!
Man your videos have me so excited to start medical school in a few weeks. Thanks for the great content
This is a fantastic video, Quinnipiac trains excellent providers.
This was super interesting!
Fantastic video. This machine is so hi tech compared to the machines I worked with 30 years ago !
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✨
Good for you, good luck
@@pamgamble7506 Thank you! I appreciate that 😊
Super informative, please keep them ocming
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…
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.
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.
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.
Such an informative video! What a knowledgeable Perfusionist as well Bravo brother!
Are you finally an official anesthesiologist?
Outstanding video!
Very interesting, thanks for sharing! Great video!!
Amazing we thank all medial staff in the world
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.
Thanks Dr. Max!
Simply thank you!
Great video! I have a question. How do they clean and resterilize the machine after using ? Do they reuse same tubes and canulas ?
Great video Max! Thank you 🎉
What a smart and handsome perfusionist! Is he single? 😉🖤 great video guys!
Thank you for the video;)
Look how big that machine has to be in comparison to our lungs and heart... Our body is freaking amazing!! 😊
THIS is an amazing !
You sir earned yourself a subscription 👍🏽
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.
Great video!!! 🙌🏻
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
Im a medical equipment planner. Very helpful video. I know the equipment but I don’t know how it works all of the time.
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!
Outstanding!
Dude thank you for this. Coming from a CA-1
Good tutorial.
How much blood is in the circuit? Does the heat lung machine have to be preloaded with fluid?
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.
This makes me want to go back to school for perfusion
Be interesting to hear your views on 'pumphead' or Postperfusion syndrome.
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.
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"?
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 !
Great video so interesting
Is this the same as ECMO?
cool stuff!
It sounds like the perfusionist is not an MD? Is that correct, or did he just leave out the med school part?
Perfusionist usually have a Master degree and are not MDs.
A perfusionist is not an MD, it is a separate program at the college level in Canada
that looks similar to hemodialysis machines. i think those are fascinating.
Thank you for the excellent video! I have a question that only a perfusionist can answer: How do you feel working as a perfusionist?
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...
Foreal lol stuff like that is genuinely scary to think about just imagine a blue screen mid surgery
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?
Max , have you ever heard the term "pump head " in regards to cabg and being on the " pump" ? Thanks !
Sooooo good
How do you clean the machine?
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.
What about keeping blood flowing through the lungs?
Interesting !
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.
Excellent video.
15:18 Jesus they're running Windows 11 on that machine.
Hello bro thanks this video
I’m going in for robotic bypass in 4 weeks, I’m pretty freaked out 😳
How is all this cleaned after use?
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.
so basically why ECMOs cant be used during surgeries as they are pretty similar things?
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.
Who invented this machine 🤯
I have coronary artery disease and congestive heart failure. I take 11 pills per day. I wonder why they can't do a bypass on me and give me new arteries.
making me want to back to school after finishing my Ph.D
i want to apply to perfusionist school :))
Bilateral pulmonary lobectomy
So ECMO is nothing like ECTO, as in Ecto-Cooler.
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.
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.
At 15:30 there is a machine that says SECHRIST... That would be with or without an appointment ??? 😱😁
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.
Kuddos to people in this field because i couldn't do this!
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?
I call this the heaven jump because people die and come back
We really need food coloring to see how that ventilator flow path works