FROM RUSSIA WITH – A HEART-LUNG MACHINE

A short weekend dip into obscure history: The Cardiohelp ECMO machine is an impressive piece of equipment, but the origins of the heart-lung machine is equally impressive for its time – even if the experiments are rather animal unfriendly. The following film is a documentary on the Soviet research by Sergei Brukhonenko in the 1940s, using his self-invented “Autoinjektor”, and led to professor Vishnevsky performing the first Soviet open-heart operation in 1957.

The film is slightly sensationalistic and seems to consist, at least in part, of re-enactments of the experiments rather than real experiment footage. It gives a feeling of watching Plan 9 From Outer Space instead of serious research, but the experiments described in the movie were actually carried out by Brukhonenko, and seem to be the first successful use of a heart-lung machine.

The Autoinjektor
Brukhonenko’s Autoinjektor was used for several open heart operations in dogs, but as the first iterations relied on a dog’s lung for blood oxygenation, it wasn’t used in humans. Later, Brukhonenko made a bubble oxygenator to work as an artificial lung.

Of course, using a heart-lung machine in humans was first done by Gibbon in the US. The first successful use was on March 6th 1953. Gibbon had worked on developing his heart lung machine for over twenty years, after seeing a patient dying from a pulmonary embolous, and wanting to be able to cure similar cases. After the first successful case, Gibbon later stopped using his invention as too many of his patients on heart-lung machine died on the operating table. It was only later, in the 60’s that further developement of Gibbon’s heart-lung machine and accompanying supportive care had advanced and made its use safer – but still much higher risk than we see today.

ECPR in the 1950s
Brukhonenko even played with the thought of reviving dead patients using his Autoinjektor, and tried it on a few cases – they were all unsuccessful. 50-60 years down the line, people are at it again – but this time with better results.

The articles linked to below are entertaining and interesting reads of those early days of artificial heart-lung support, and with further references for those with a special interest. If the Internet had been around at the time, there would have been some interesting FOAM discussions between Gibbon, Brukhonenko and their peers.

dogs head
Brukhonenko far left, with an experiment on perfusing an isolated dog’s head,
with one iteration of the Autoinjektor in the background.

Sergei S. Brukhonenko: The Development of the First Heart-Lung Machine for Total Body Perfusion, Ann. Thoracic Surgery, 2000.

Off with your heads: isolated organs in early Soviet science and fiction, 2009.

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