Innovations in Pedriatic Cradiopulmonary Bypass: a continuous process of quality improvement

Cardiopulmonary bypass (CPB) is defined as a technique that temporarily replaces the function of the heart and lungs, maintaining an adequate blood circulation and oxygen content of the body during surgery of the heart and great vessels. The current practice of cardiopulmonary bypass was achieved through the efforts of a numbers of individuals who believed that artificial cardiopulmonary support could replace the body’s own circulatory and respiratory systems. Collaborative efforts of physiologists, chemists, physicists, engineers, and physicians led to design and development of synthetic devices that could effectively sustain patients who required corrective surgical procedures of treatable lesions of the heart, lungs or other vital organs. In 1937, Gibbon reported the first successful total cardiopulmonary bypass of an animal (cat) with the use of heparin, a Dale-Schuster-type pump, and a vertical rotating cylinder oxygenator. However, it was not until 1951 that cardiopulmonary bypass was applied in a patient, enabling an unobstructed view of intracardiac lesions. In Minneapolis on the 5th of April 1951, Dennis and his associates performed the first total cardiopulmonary bypass in a 6-year old patient with an endocardial cushion defect. Unfortunately, the patient could not be weaned from the bypass and died on the table because of cardiac failure. Gibbon, who considered to be the “father of cardiopulmonary bypass”, together with his wife Mary refined the work of Dennis and successfully performed on the 20th of May 1953 in Philadelphia the closure of an atrial septal defect in an 18-years old patient. This moment marked in the history of cardiopulmonary bypass the beginning of the “applied technology period” that lasted from 1950 to 1970. The “refinement period” has followed and lasts until present.

• View at Worldcat

Free Full Text ( Final Version , 3mb )