99191 Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 45 minutes

Name of the Procedure:

Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 45 minutes

Summary

This procedure involves setting up and operating a medical device that helps manage a patient's blood flow, oxygenation, and temperature during surgeries or critical care. The device includes a pump, an oxygenator, and, optionally, a heat exchanger and monitoring equipment.

Purpose

The procedure is designed to support or replace the function of the heart and lungs during medical treatments. The goals are to maintain adequate circulation, oxygenation, and temperature control of the patient's blood.

Indications

• Cardiac surgeries (e.g., open-heart surgery)
• Severe respiratory failure
• Certain types of trauma or severe infections
• Conditions where the heart and lungs need temporary support

Preparation

• Patients may need to fast for a few hours prior to the procedure.
• A complete medical history and physical examination are required.
• Pre-procedure tests typically include blood work, ECG, and imaging studies.

Procedure Description

1. Setup: Assemble the pump, oxygenator, and heat exchanger per manufacturer guidelines.
2. Connection: Connect the system to the patient's vascular access points or surgical site.
3. Monitoring: Attach ECG and pressure monitoring devices, if used.
4. Operation: Initiate the pump to circulate blood through the oxygenator (adds oxygen) and heat exchanger (regulates temperature).
5. Maintenance: Monitor and adjust settings continuously to ensure optimal function.

Tools and Equipment:

• Blood pump
• Oxygenator
• Heat exchanger
• ECG and pressure monitors

Anesthesia:

• General anesthesia is typically used if the procedure is part of a surgery.

Duration

The procedure typically takes 45 minutes to set up and initiate.

Setting

This procedure is usually performed in a hospital, particularly in an operating room or intensive care unit.

Personnel

• Cardiothoracic surgeon or perfusionist specialist
• Nurses
• Anesthesiologist
• Monitoring technicians

Risks and Complications

• Bleeding
• Blood clot formation
• Infection
• Device malfunction
• Air embolism

Benefits

• Maintains adequate oxygen and nutrient delivery to tissues during surgery or critical care.
• Supports organ function while underlying issues are addressed.
• Rapid stabilization of critical patients.

Recovery

• Continuous monitoring in ICU or post-operative unit.
• Pain management as needed.
• Gradual return to normal activities; follow-up care depends on the underlying condition.

Alternatives

• Conventional mechanical ventilation
• Heart-lung machine
• Extracorporeal membrane oxygenation (ECMO)

Each alternative has its own set of benefits and risks which should be compared with the needs of the patient.

Patient Experience

The patient will be under anesthesia or sedation during the procedure and will not feel any discomfort. Post-procedure, patients may feel weak or tired and will be under close medical observation. Pain and discomfort are managed with medication and supportive care.