Editing Cardiopulmonary bypass (section)

==History==
[[File:1955 heart lung machine.jpg|thumb|upright=0.6|right|A heart lung machine used in London's [[Middlesex Hospital]] in 1958. [[Science Museum, London]] (2008)
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[[File:Cardiopulmonary bypass machine.jpg|thumb|upright=0.6|Cardiopulmonary bypass machine used at the University of Michigan in the 1960s.]]The Austrian-German physiologist [[Maximilian von Frey]] constructed an early prototype of a heart-lung machine in 1885. This was conducted at [[Carl Ludwig]]'s Physiological Institute of the [[University of Leipzig]].<ref>{{cite journal |vauthors=Zimmer HG |date=September 2003 |title=The heart-lung machine was invented twice&mdash;the first time by Max von Frey |journal=Clinical Cardiology |volume=26 |issue=9 |pages=443–5 |doi=10.1002/clc.4960260914 |pmc=6654655 |pmid=14524605}}</ref> However, such machines were not feasible before the discovery of [[heparin]] in 1916, which prevents blood [[coagulation]].

The Soviet scientist [[Sergei Brukhonenko]] developed a heart-lung machine for total body perfusion in 1926 named the ''Autojektor'', which was used in experiments with dogs, some of which were showcased in the 1940 film ''[[Experiments in the Revival of Organisms]]''. A team of scientists at the [[University of Birmingham]] (including Eric Charles, a chemical engineer) were among the pioneers of this technology.

For four years work was undertaken to improve the machine, and on April 5, 1951, Dr. [[Clarence Dennis]] led the team at the [[University of Minnesota Medical Center]] that conducted the first human operation involving open cardiotomy with temporary mechanical takeover of both heart and lung functions. The patient did not survive due to an unexpected complex congenital heart defect, but the machine had proved to be workable.<ref name="Dennis">{{cite journal | vauthors = Dennis C, Spreng DS, Nelson GE, Karlson KE, Nelson RM, Thomas JV, Eder WP, Varco RL | display-authors = 6 | title = Development of a pump-oxygenator to replace the heart and lungs; an apparatus applicable to human patients, and application to one case | journal = Annals of Surgery | volume = 134 | issue = 4 | pages = 709–721 | date = October 1951 | pmid = 14878382 | pmc = 1802968 | doi = 10.1097/00000658-195110000-00017 }}</ref><ref>{{cite book|url=https://archive.org/details/bub_gb_pCEDAAAAMBAJ|page=[https://archive.org/details/bub_gb_pCEDAAAAMBAJ/page/n105 4]|title=Popular Science |date=1 February 1951|publisher=Bonnier Corporation|via=Internet Archive|access-date=4 April 2018}}</ref> One member of the team was Dr [[Russell M. Nelson]], (who later became president of [[The Church of Jesus Christ of Latter-day Saints]]), who performed the first successful open heart surgery in [[Utah]] on November 9, 1955 at Salt Lake General Hospital.<ref>{{cite web|url=https://healthcare.utah.edu/publicaffairs/news/2015/Russell_Nelson_60_heart_anniversary.php|title=Celebrating 60 Years of Cardiac Surgery in Utah With Russell M. Nelson, M.D.|publisher=University of Utah|url-status=dead|archive-url=https://web.archive.org/web/20180117131234/https://healthcare.utah.edu/publicaffairs/news/2015/Russell_Nelson_60_heart_anniversary.php|archive-date=17 January 2018|access-date=4 April 2018}}</ref>

The first successful mechanical support of left ventricular function was performed on July 3, 1952, by [[Forest Dewey Dodrill]] using a machine co-developed with General Motors, the [[Dodrill-GMR]]. The machine was later used to support the right ventricular function.<ref>{{cite book |url=https://archive.org/details/surgerybasicscie00nort |title=Surgery: Basic science and clinical evidence |vauthors=Norton J |publisher=Springer |year=2008 |isbn=978-0-387-30800-5 |location=NY |pages=[https://archive.org/details/surgerybasicscie00nort/page/n1473 1473] |url-access=limited}}</ref>

The first successful open heart procedure on a human utilizing the heart lung machine was performed by [[John Heysham Gibbon|John Gibbon]] and Frank F. Allbritten Jr. on May 6, 1953, at [[Thomas Jefferson University Hospital]] in [[Philadelphia]].<ref>{{cite journal |vauthors=Hedlund KD |date=2001 |title=A Tribute to Frank F Alibritten, Jr. Origin of the left ventricular vent during the early years of open-heart surgery with the Gibbon heart-lung machine |journal=Texas Heart Institute Journal |volume=28 |issue=4 |pages=292–6 |pmc=101205 |pmid=11777154}}</ref>  Gibbon's machine was further developed into a reliable instrument by a surgical team led by [[John W. Kirklin]] at the [[Mayo Clinic]] in [[Rochester, Minnesota]] in the mid-1950s.<ref>"[https://www.uab.edu/newsarchive/42933-john-kirklin-cardiac-surgery-pioneer-dead-at-age-86 John Kirklin Cardiac Surgery Pioneer Dead at Age 86]." (April 23, 2004) University of Alabama at Birmingham. press release</ref>

The [[oxygenator]] was first conceptualized in the 17th century by [[Robert Hooke]] and developed into practical extracorporeal oxygenators by French and German experimental physiologists in the 19th century. Bubble oxygenators have no intervening barrier between blood and oxygen, these are called 'direct contact' oxygenators. [[Membrane oxygenator]]s introduce a gas-permeable membrane between blood and oxygen that decreases the [[clotting|blood trauma]] of direct-contact oxygenators. Much work since the 1960s focused on overcoming the gas exchange handicap of the membrane barrier, leading to the development of high-performance microporous hollow-fibre oxygenators that eventually replaced direct-contact oxygenators in cardiac theatres.<ref name="Lim 2006">{{cite journal | vauthors = Lim MW | title = The history of extracorporeal oxygenators | journal = Anaesthesia | volume = 61 | issue = 10 | pages = 984–995 | date = October 2006 | pmid = 16978315 | doi = 10.1111/j.1365-2044.2006.04781.x | s2cid = 24970815 | doi-access =  }}</ref>

In 1983, Ken Litzie patented a closed emergency heart bypass system which reduced circuit and component complexity.<ref>{{Cite patent|country=US|number=4540399|title=US Patent for Emergency bypass system|gdate=10 September 1985|inventor=Litzie K, Roberts CP|assign1=C.R. Bard, Inc|assign2=Lifestream International, LLC|url=https://patents.justia.com/patent/4540399|postscript=.}}</ref> This device improved patient survival after cardiac arrest because it could be rapidly deployed in non-surgical settings.<ref>{{cite journal |display-authors=6 |vauthors=Reichman RT, Joyo CI, Dembitsky WP, Griffith LD, Adamson RM, Daily PO, Overlie PA, Smith SC, Jaski BE |date=January 1990 |title=Improved patient survival after cardiac arrest using a cardiopulmonary support system |journal=The Annals of Thoracic Surgery |volume=49 |issue=1 |pages=101–5 |doi=10.1016/0003-4975(90)90363-B |pmid=2297254 |doi-access=free}}</ref>