How Long Can A Person Remain On A Heart-Lung Machine (And Why)?

Exact Answer: Up to 3 months

Patients suffering from acute cardiomyopathy are kept alive using a special life support system known as the heart-lung machine. This electronic device is also known as the cardiopulmonary bypass machine. Using this machine ensures that it takes over the circulatory functions of the patient’s heart.

A patient is hooked onto the heart-lung machine prior to all major surgical procedures performed on a defective heart. It helps take over the heart’s functions, keeping the organ still for the doctors to operate on it. In seriously ill patients, who are suffering from respiratory issues, a heart-lung machine can be prescribed by the physician as the optimal life support mechanism.

How Long Can A Person Be On A Heart-Lung Machine

The primary care physician supervising a patient’s case decides on the upper limit of using the heart-lung machine. The chief rationale for using it for any duration of time is to ensure that the affected individual’s heart and lungs, both can have enough time to recover from the stress of performing their stipulated functions.

In the event of any major cardiac surgery, doctors will insist on using a heart-lung bypass machine as they need the organs to remain steady when they are operating on them. This implies that the patient will remain on the heart-lung machine and breathe through an attached ventilator for the entire duration of the surgery. This may mean using the machine for several hours.

When fixing major cardiac defects like stenosis and regurgitation, doctors insist on using the bypass machine. This helps them fix these problems more effectively and efficiently. Apart from repairing the heart’s valves, doctors also use the heart-lung machine during a artery bypass procedure.

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It is important to cognize that all these procedures can take up to 20 to 25 hours to be completed and the patient must continue using the machine for the entire duration of the procedure.

Alternatively, when the patient is in a coma, after an accident, or a severe system failure, a heart-lung bypass machine can be used to provide the individual life support. In such cases, the maximum period of using the machine was 3 months. After this interval, it becomes very difficult to revive the patient in the absence of any signs of recovery.

In Summary:

Purpose of UsageTime Spent on the Machine
Cardiac SurgeriesUp to 25 hours (or as long as the surgery lasts)
Recuperating in a ComaUp to 3 months

Why Does A Person Need To Be On The Heart-Lung Machine For So Long?

A patient needs to continue using the heart-lung bypass for a considerable period of time because generally, the surgeons need time to fix the defects in a heart. Operating surgeons will sedate the patient and opt for a bypass procedure because they wish to accord the organs sometime to recover. By stopping the heart, they make such operations easier and much more efficient.

The circulation of the patient’s body is taken over by the heart-lung bypass machine. The machine also coopts the patient’s breathing functions. This allows the team of surgeons assigned on the case to perform the operation with a clear field of vision, without the beating of the heart.

As most cardiac procedures are quite detailed, it takes hours to finish such surgeries. Meticulously handling the delicate heart and lung tissues takes time and concentration. Thus, surgeons prefer that patients remain on a by-pass machine during the entire procedure.

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There are also less invasive ways of performing these surgical procedures, which would eliminate the need for a by-pass machine. However, this would require the surgeons to compromise on their visual field. The less invasive procedures do not accord them a clear view of the heart and this can lead to other complications.

Moreover, it takes time to wean the patient off the machine. Using a heart-lung bypass machine necessitates that the core temperature of the patient’s body is cooled. This temperature has to be brought back up again before the patient can be weaned off the machine successfully.

Conclusion

Using a heart-lung bypass machine during major cardiovascular surgeries has evolved into the standard norm. There are very few surgeons who will opt for microsurgery on a major heart defect simply because it negates the use of the heart-lung bypass machine.

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Most patients are weaned off the machine as soon as the procedure is completed. Once the core objective of letting the artificial machine perform the circulatory and respiratory functions is completed, it can be unhooked from the concerned patient. Sometimes when patients are in comas, they can remain alive on the machine for a few months. In such cases, it acts as a prudent life support mechanism.

References

  1. https://www.annalsthoracicsurgery.org/article/S0003-4975(03)01826-5/abstract