Assembly and operation of pump with oxygenator or heat exchanger (with or without ECG and/or pressure monitoring); 30 minutes
CPT4 code
Name of the Procedure:
Assembly and Operation of Pump with Oxygenator or Heat Exchanger (with or without ECG and/or pressure monitoring); 30 minutes
Summary
This procedure involves setting up and managing a machine that pumps blood through an oxygenator or heat exchanger. This machine ensures that the patient's blood remains oxygenated and at the right temperature during certain medical treatments.
Purpose
This procedure is used to maintain proper oxygen levels and temperature in the blood during surgeries or treatments where the heart or lungs cannot perform these functions effectively. It aims to support the patient's cardiovascular and respiratory systems to ensure their safety and optimize surgical outcomes.
Indications
The procedure is indicated for patients undergoing cardiac surgery, extracorporeal membrane oxygenation (ECMO) for severe respiratory failure, or hypothermia treatment. Criteria for the procedure include severe cardiac or respiratory dysfunction and specific surgical requirements necessitating temporary heart and lung support.
Preparation
Patients may be instructed to fast for a certain period before the procedure and may need to adjust their medication regimen based on physician recommendations. Diagnostic tests such as blood work, ECGs, and imaging studies might be required prior to the procedure.
Procedure Description
- The healthcare team prepares and sterilizes the equipment, including the pump, oxygenator, or heat exchanger.
- An intravenous line or catheter is inserted to connect the patient’s blood flow to the machine.
- The machine is assembled and calibrated to the patient-specific requirements.
- Blood is routed from the patient through the machine, where it is oxygenated or temperature-adjusted, then returned to the patient.
- Continuous monitoring of ECG, pressure, and oxygen levels is maintained to ensure proper operation and patient safety.
- Adjustments are made as needed according to real-time measurements and patient responses.
Tools used include the pump, oxygenator, heat exchanger, ECG monitors, and pressure monitors. Depending on the complexity, local or general anesthesia may be administered.
Duration
The procedure typically takes about 30 minutes to complete.
Setting
This procedure is generally carried out in a hospital setting, often in an operating room or a specialized intensive care unit.
Personnel
A team of healthcare professionals including a surgeon, perfusionist, anesthesiologist, and nurses will be involved in the procedure.
Risks and Complications
Common risks include bleeding, infection, and complications related to blood clotting. Rare risks involve mechanical failures of the device, which can be managed by the medical team through contingency protocols.
Benefits
The main benefit is maintaining adequate oxygenation and temperature of the blood during critical periods, which helps in achieving better surgical outcomes and patient safety. Benefits are typically realized immediately during and after the procedure.
Recovery
Post-procedure care includes monitoring in an intensive care unit, where vital signs and blood parameters are closely watched. The recovery period varies but generally includes gradual weaning off the mechanical support as the patient stabilizes.
Alternatives
Alternative treatments may include medications or other supportive treatments to manage heart or lung function. Compared to the described procedure, alternatives may be less invasive but could have different efficacy levels depending on the patient's condition.
Patient Experience
During the procedure, patients are usually under anesthesia, so they will not feel anything. After the procedure, there may be some discomfort at catheter sites, which can be managed with pain medication and comfort measures provided by the healthcare team.