Correspondence
In Reply
;
We thank Drs Ehrentraut and Schewe for their critical comments on our article (1). We hold perfusionists’ expertise in high regard as they collaborate closely in heart operations as part of the surgical team especially with cardiac surgeons and cardiac anesthetists. The modern approach of surgical intensive medical teams is interdisciplinary and interprofessional (2). This underlines the importance of perfusionists who are familiar with using heart-lung machines and ECMOs as a result of handling these on a daily basis. Contrary to the view expressed by Ehrentraut and Schewe, this reduces the workload of the nursing staff. This division of labor enables the chronically overworked nurses to devote their attention to other tasks. Furthermore, additional care provided by perfusionists aims to consider technical aspects of the ECMO technology with a special focus on early detection and prevention of technical failures of the pump.
We also wish to emphasize that in ECMO and ECLS treatment, it is not only the implantation procedure that is crucial, but also the management during the treatment on the intensive care unit. ECMO implantation—especially veno-venous implantation—can obviously be carried out by a small experienced team. And we congratulate Ehrentraut and Schewe on their experiences with the interhospital transport of patients with ECMO, accompanied by such a team. They completely meet the requirements of the S3 and ELSO guidelines (3, 4). However, we still think it is of utmost relevance in the future to include the professional group of perfusionists in these guidelines. Especially difficult and complication-bound situations can be identified early when perfusionists are involved, or at least they can be handled better. Perfusionists have expertise that should not be underestimated, and which we would not miss in our center.
DOI: 10.3238/arztebl.m2022.0237
On behalf of the authors
PD Dr. med. Alexander M. Bernhardt
Prof. Dr. Dr. med. Hermann Reichenspurner
Universitäres Herz- und Gefäßzentrum
Universitätsklinikum Hamburg-Eppendorf
al.bernhardt@uke.de
Conflict of interest statement
PD Bernhardt has served as a paid consultant for Abbott, Abiomed, BerlinHeart, and Medtronic, companies that are active in the field with which this review is concerned. He has received lecture honoraria from Abbott, Abiomed, AstraZeneca, BerlinHeart, Medtronic, and Novartis.
Prof. Reichenspurner is on the Advisory Board of Medtronic and received lecture fees from Medtronic and Abiomed.
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