Evolution of Cardiopulmonary Bypass

Abstract

A t the end of the Second World War, the devastation of many cities in Europe, combined with the problems of reconstruction and loss of financial support, had brought European medical research to a halt.On the other hand, in the United States the war brought about an enormous amount of scientific research through the development of nuclear weapons, the mass production of penicillin, early computers, and a variety of other technological advances, some of which were eventually put to use by medical investigators.In the immediate postwar years, Congress began 3 decades of generous funding for medical research and education through the National Institutes of Health and the Public Health Service.In the 1920s and 1930s, medical research money had been scarce, but after the war there was a flood of money.The National Institutes of Health budget for medical research in 1945 was $180 000.By 1947, it was increased to $4 000 000, in 1950 to $46 000 000, and in 1974 to $1 billion. 1 By 2008, the total budget just for the Heart, Lung, and Blood Institute was almost $3 billion.Since colonial times, it had been customary for young American physicians to spend postgraduate time in Vienna, Berlin, London, or Paris.Now the opposite was true.It became important for a young European physician to have worked for a year or so in a US medical center.The world center for medical education and research had shifted from Europe to the United States.Postwar medical progress was also stimulated by several other programs.The Hill-Burton act of 1946 provided funds for community hospital upgrades and construction.Initially this bill provided $75 million per year for 5 years.It was a matching plan in which local hospitals were required to raise two thirds of the new construction costs, and each hospital that received federal money was required to provide a reasonable amount of care for those who could not pay.During this same period, the Veterans Administration adopted a policy of building new hospitals in urban settings and wherever possible developed an affiliation with the nearest medical school.This gave medical schools a major voice in selecting the medical and surgical staff.Thus, the Veterans Hospitals provided positions for medical school faculty and patients for medical student and house staff education.Finally, in 1965 Congress passed the Medicare and Medicaid bill, which paid not only the hospital costs of the elderly

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