Cardiovascular Perfusion Services/Extracorporeal Life Support (ECLS)/ Advanced Technologies (AT) Program
The Cardiovascular Perfusion Services/Extracorporeal Life Support (ECLS)/Advanced Technologies (AT) Program is a specialized service within the Labatt Family Heart Centre. A Cardiovascular Perfusionist provides expertise in extracorporeal (outside the body) circulation to support a patient’s cardiopulmonary function. This means they utilize equipment and techniques to pump and oxygenate a patient’s blood when the patient’s heart and/or lungs are unable to do so.
The main focus of the Cardiovascular Perfusionist is in the cardiac surgical operating room where they operate the heart-lung machine to maintain blood circulation, oxygenation and other vital parameters during the patient’s surgery. Cardiovascular Perfusionists at SickKids are all specifically trained to manage the needs of newborns and children undergoing surgery for complex congenital heart defects, heart and/or lung transplants and acquired cardiac/pulmonary diseases requiring corrective repair. Additionally, these services can be required for patients undergoing interventional procedures in the Cardiac Diagnostic Imaging Unit (CDIU) providing cardiopulmonary support to children with critical anomalies or arrhythmias.
Extracorporeal Membrane Oxygenation (ECMO)
The use of extracorporeal technologies extends beyond the operating room to the critical care units under the heading of the Extracorporeal Life Support (ECLS) Program. Here, the Cardiovascular Perfusionist utilizes a scaled-down version of the heart-lung machine to provide cardiopulmonary support to critically ill patients requiring emergent resuscitation as well as short to long-term support for rest and recovery of their heart and/or lung function. This system, called Extracorporeal Membrane Oxygenation or ECMO, is always ready to be employed at a moments notice. To achieve this, Cardiovascular Perfusionists work very closely with Registered Respiratory Therapists and Registered Nurses who are certified as ECMO Specialists training them in the rapid deployment and management of the ECMO systems around the clock.
Our Cardiovascular Perfusionists, in collaboration with a large interdisciplinary team, have modified the ECMO system to be highly mobile for the goal of providing cardiopulmonary support to patients who are too unstable to be transported by ambulance or aircraft using existing techniques. Transport ECMO, as it is called, is a modality offered by only a handful of centers world-wide expanding the reach of SickKids to encompass very critically ill children in outlying hospitals.
Bridge to Transplant
ECLS not only includes the use of ECMO, but ventricular assist devices (VAD) and interventional lung assist devices as well. The Berlin Heart and HeartWare VAD’s are currently utilized at SickKids as a long-term device used to support the failing heart of a patient awaiting a transplant. Similarly, the Novalung is a long-term support device for transplant patients with failing lungs. The Cardiovascular Perfusionist is integral in the preparation, implantation and management of patients requiring these devices.
SickKids has a long standing tradition of fostering meaningful research and the Cardiovascular Perfusion Services/ECLS/AT Program strives to carry this tradition forward. Through collaborative research with interdisciplinary teams as well as independent research, our Perfusionists labor to improve the process of extracorporeal systems. Some areas of current focus are the miniaturization of cardiopulmonary bypass circuits and improvements in the management of anticoagulation throughout the perioperative period. The goal of these improvements is to decrease the need for donor blood transfusions leading to quicker recovery times.
New knowledge learned through research is translated via presentations at national and international medical conferences as well as peer reviewed journal publications. Additionally, our Perfusionists volunteer their time and expertise to train the global medical community by participation in medical missions to foreign countries. This transfer of knowledge through education is a cornerstone of SickKids commitment to the advancement of world health.
How to Contact Us
Perfusion Services/ECLS/AT Program
555 University Avenue
2nd Floor – Black Wing, Room 2311
Toronto, Ontario M5G 1X3