{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:01:47Z","timestamp":1777669307442,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL126896"],"award-info":[{"award-number":["R01HL126896"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hum Factors"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This novel preliminary study sought to capture dynamic changes in heart rate variability (HRV) as a proxy for cognitive workload among perfusionists while operating the cardiopulmonary bypass (CPB) pump during real-life cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Estimations of operators\u2019 cognitive workload states in naturalistic settings have been derived using noninvasive psychophysiological measures. Effective CPB pump operation by perfusionists is critical in maintaining the patient\u2019s homeostasis during open-heart surgery. Investigation into dynamic cognitive workload fluctuations, and their relationship with performance, is lacking in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>HRV and self-reported cognitive workload were collected from three Board-certified cardiac perfusionists ( N = 23 cases). Five HRV components were analyzed in consecutive nonoverlapping 1-min windows from skin incision through sternal closure. Cases were annotated according to predetermined phases: prebypass, three phases during bypass, and postbypass. Values from all 1min time windows within each phase were averaged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cognitive workload was at its highest during the time between initiating bypass and clamping the aorta (preclamp phase during bypass), and decreased over the course of the bypass period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified dynamic, temporal fluctuations in HRV among perfusionists during cardiac surgery corresponding to subjective reports of cognitive workload. Not only does cognitive workload differ for perfusionists during bypass compared with pre- and postbypass phases, but differences in HRV were also detected within the three bypass phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Application<\/jats:title>\n                    <jats:p>These preliminary findings suggest the preclamp phase of CPB pump interaction corresponds to higher cognitive workload, which may point to an area warranting further exploration using passive measurement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0018720820976297","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T23:30:09Z","timestamp":1608161409000},"page":"757-771","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of Dynamic Changes in Cognitive Workload During Cardiac Surgery Perfusionists\u2032 Interactions With the Cardiopulmonary Bypass Pump"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2696-3943","authenticated-orcid":false,"given":"Lauren R.","family":"Kennedy-Metz","sequence":"first","affiliation":[{"name":"VA Boston Healthcare System, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger D.","family":"Dias","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rithy","family":"Srey","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey C.","family":"Rance","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather M.","family":"Conboy","sequence":"additional","affiliation":[{"name":"University of Massachusetts, Amherst, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel E.","family":"Haime","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacquelyn A.","family":"Quin","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Yule","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"University of Edinburgh, Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco A.","family":"Zenati","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"bibr2-0018720820976297","first-page":"175","volume":"2018","author":"Avrunin G. 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