Cardiopulmonary bypass: risk management concerns for the anesthesiologist

Perfusionists have a critically important role in cardiac surgery. Their responsibilities include providing cardiovascular support, maintaining adequate blood flow and blood pressure, maintaining adequate oxygenation, operating suction pumps and other devices, regulating blood temperature, and keeping records. The relationship between perfusionist and anesthesiologist as members of the cardiac surgical team should be one of mutual support. Although many anesthesiologists do not control the pharmacology of perfusion, it is their responsibility to ensure that the perfusionist understands the pharmacopeia being used and to know what the perfusionist is administering. In-depth knowledge of the techniques and practices of cardiopulmonary perfusion is a prerequisite for cardiac anesthesiologists. The future is likely to see an increasingly supportive relationship between anesthesiologists and perfusionists.