History of extracorporeal circulation: the conceptional and developmental period.

The development of modern techniques in extracorporeal circulation is the result of the combined efforts of physiologists, physicians, and engineers. Early experimental work at the end of the 19th century was accomplished by physiologists, such as von Schröder, von Frey, and Gruber, as well as Jacobj. These scientists laid the foundation for three different artificial oxygenation devices for experimental isolated animal organ perfusion. The developed bubble, film, and isolated lung oxygenation methods developed were later used for the first clinical cardiopulmonary bypass procedures in humans. For continuous perfusion experiments, closed circulation circuits were put into use. In a second step, during the first half of the 20th century, scientists and physicians, such as Brukhonenko, Gibbon, Crafoord, Björk, and Jongbloed were working on the refinement of these methods for intended application during cardiovascular operations in humans. Refined bubble and film oxygenators together with the modern blood pumps in closed circulatory systems were assembled as pump oxygenators, later called heart-lung machines. They were used in the first clinical cases of extracorporeal circulation for heart surgery in the second half of the 20th century by Dennis, Dogliotti and Constantini, and Gibbon.