Introduction: In Europe, cardiovascular diseases are the most common cause of death, with over 4 million people dying from their consequences each year. Cardiovascular diseases are the leading cause of death in Slovenia as well, accounting for 38 % of all deaths in 2019 and 32 % in 2020. For most open-heart surgeries, a perfusionist must be present to maintain the extracorporeal blood circulation during the operation and provide a still heart if necessary, enabling the surgeon to operate bloodlessly and smoothly. This is achieved by using cardioplegia solutions. Purpose: To present the tasks of perfusionists in the application and monitoring of cardioplegia, what equipment they need to perform the procedure, and which solutions they use at the University Medical Centre Ljubljana. Methods: In the empirical part we conducted semi-structured interviews with three perfusionists employed at the University Medical Centre Ljubljana, each with at least 9 years of work experience. The interview consisted of 5 main questions and several sub-questions. They were conducted at the University Medical Centre Ljubljana and were voice recorded. We transcribed them verbatim and conducted open coding for analysis. Results: To be employed as a perfusionist, a registered nurse with a bachelor's degree must have at least two years of work experience in the intensive care unit III. The newly employed perfusionist undergoes a two-year training period, followed by supervised independent work. To perform cardioplegia they need a pump, tubing system, heat exchanger with corresponding tubing, and a hyperkalemic solution. They always have several forceps nearby, which can reduce or stop blood flow in the system instantly. They use three different solutions for cardioplegia: St. Thomas, del Nido, and Custodiol. The surgeon always decides how cardioplegia will be applied, as they can see and assess the most appropriate method in a given situation. The goal of every surgeon is to minimize the duration of extracorporeal blood circulation. Discussion and conclusion: The work of perfusionists is very specific and responsible. It requires a great deal of knowledge about blood biochemistry, as well as an understanding of the anatomy, physiology, and pathology of the cardiovascular system. In addition to professional knowledge, they also need technical skills to assemble complex tubing and operate pumps. For a successful open-heart surgery, a perfusionist must communicate constantly with the surgeon and anesthesiologist.
|