Back to the stacks--looking at classic papers related to the current practice of cardiopulmonary bypass.

A number of philosophers and writers have eloquently expressed the importance of understanding the past. “If you would understand anything, observe its beginning and its development” Aristotle “History teaches everything including the future” Alphonse Lamartine “Life must be lived forward, but it must be understood backward” Soren Kierkegaard “Those who cannot remember the past are condemned to repeat it” George Santayana “If history repeats itself, and the unexpected always happens, how incapable must man be of learning from experience?” George Bernard Shaw The history of perfusion in the perfusion literature is filled with examples of “discoveries” of new technology and “new” applications of technology. Many of these are simply “reinventions” of techniques that were previously described. One example is John Gibbon’s use of vacuum assist for venous return. His Mayo Gibbon pump used suction to augment the venous return. Following the simplification of the cardiopulmonary bypass circuit to gravity drainage, vacuum-assist was later reintroduced again in the early 1990s. There are numerous examples of early attempts to improve bypass that were “rediscovered” later. The modern computer age has made searching for references and remote access to the current literature very easy. In the past, it was necessary to actually go to the library and search in Index Medicus for subjects related to cardiopulmonary bypass. However, there are still a limited number of full articles available online. The Annals of Thoracic Surgery and the Journal of Thoracic and Cardiovascular Surgery are available from January 1, 1995. The Journal of ExtraCorporeal Technology (JECT) is now available on line from 1972. A limited amount of the Proceedings from the American Academy of Cardiovascular Perfusion (AACP) are available electronically. The journal Perfusion started publishing peer-reviewed AACP presentations in 1995 and Perfusion is available electronically online from January 1, 1997. The ASAIO journal is available online from January 1, 2000. Except for JECT, only the most recent (last 15 years) are available and many of the best years of the development of perfusion technology are not available electronically. Therefore, the present day perfusion student and clinicians need to go back to the library stacks to find the journal articles that laid the foundation for our current clinical practice. Much of the research that determines current clinical practice is not available as a pdf file, but is buried in the volumes of journals that now lie dormant on the library shelves. The library building is now often empty because students have online access to journal articles. It is still important to review “classic” papers in the literature that continue to influence our practice today. The early articles that described case reports of new techniques and studies of new methodologies are critical to understanding the basis for our current clinical practice. Today, we primarily use systematic reviews and evidence based medicine to develop clinical guidelines, but the majority of our clinical practice is rooted in the “classic” research papers that influenced and changed the majority of the profession until it became a ”standard of practice.” There are many current clinical practices that are based on this literature and there will never be a doubleblinded randomized clinical trial to prove their efficacy. All we have to do is ask the questions, and the answers probably come from Guest Editorial Back to the Stacks – Looking at Classic Papers Related to the Current Practice of Cardiopulmonary Bypass