The session starts with a comprehensive review of modalities under the perfusion umbrella, categorizing services ranging from routine cardiopulmonary bypass to specialized support such as venoarterial ECMO for cardiogenic shock or isolated limb perfusion. Speakers discuss regulatory definitions from bodies such as the American Board of Cardiovascular Perfusion (ABCP), emphasizing that these modalities extend beyond the operating room into critical care. Transitioning to surgeon perspectives, the discussion examines qualities valued in perfusionists, such as precise flow management, rapid response to hemodynamic changes, and proactive circuit adjustments. Real-world examples illustrate mismatches between perfusionists' actions and surgeons' expectations, highlighting areas such as air-handling protocols and temperature control during deep hypothermic circulatory arrest. The program then integrates these topics, offering frameworks for perfusionists to self-assess and adapt. Case-based scenarios demonstrate how understanding surgeon preferences enhances outcomes in complex repairs, with emphasis on documentation and post-procedure debriefs to foster continuous improvement.

PerfWeb 111 Day 1 assesses the potential effects of Centers for Medicare and Medicaid Services (CMS) payment policies on perfusionist compensation within hospital systems. This session examines how annual updates to inpatient prospective payment systems and quality-based adjustments constrain hospital budgets, indirectly shaping salary structures and staffing models for cardiovascular perfusion teams. For perfusion leaders, it provides a framework for anticipating fiscal shifts and advocating for sustainable compensation in an era of value-based care. Learning Objectives: Explain the mechanisms of CMS hospital payment systems, including diagnostic-related groups (DRGs) relevant to cardiac procedures. Identify key changes in recent CMS rules that impact reimbursement for perfusion-supported surgeries like coronary artery bypass grafting. Evaluate how hospital revenue pressures from CMS adjustments affect perfusion department budgets and compensation packages. Differentiate between direct and indirect influences of CMS policies on perfusionist salaries, benefits, and on-call stipends. Apply strategies for perfusion services to demonstrate value through cost-efficiency metrics and quality outcomes. Assess negotiation tactics for perfusion contracts in light of hospital fiscal constraints driven by CMS. Develop a plan to monitor upcoming CMS proposals and adapt perfusion practice models accordingly.

PerfWeb 110 – Day 2 examines clinical indications for extracorporeal membrane oxygenation (ECMO) and available cannulation options, focusing on evidence-based criteria for initiation in adult patients with refractory cardiac or respiratory failure. This session addresses decision-making in high-acuity scenarios where standard therapies fail, providing perfusionists with tools to assess suitability and select appropriate access strategies. By clarifying when ECMO offers benefit versus risk, the content supports safer implementation in programs managing acute decompensations. Learning Objectives: Identify key clinical conditions, such as severe ARDS or cardiogenic shock, where ECMO provides effective temporary support. Differentiate between venoarterial (VA) and venovenous (VV) ECMO configurations based on underlying pathophysiology. Evaluate patient-specific factors influencing ECMO candidacy, including contraindications and prognostic indicators. Describe common cannulation sites and techniques, including peripheral versus central approaches. Apply strategies to mitigate cannulation-related complications like limb ischemia or recirculation. Interpret hemodynamic and gas exchange parameters to guide initial ECMO setup and adjustments.