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Principles III > Purfusion lecture ppt > Flashcards

Purfusion lecture ppt Flashcards

notes from fuck face who keeps calling us ANESTHESIOLOGIST b/c hes too fucking stupid to realize who he is giving a lecture to

1
Q

A’s of anesthesiology

A

anesthesia
analgesia
Amnesia

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2
Q

A’s of anesthetist

A

Ability
amiability
Availability

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3
Q

P’s of perfusion

A

preparation
Prime and pump
persistence
Pandering

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4
Q

Perfusion Equipment

A 
heart-lung machine
Cell saver
Heater-cooler
bloodgas machine
ACT machine
thrombelastagraph
inline bloodgass analyzer
cerebral oximeter
Disposable invetory
-oxygenators
-hemoconcentrators
-tubing packs
-cardioplegia delivery systems
-Cannulas
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5
Q

Prime:
Est adult blood volume
Adult
neonate

A

Adult:6 liters
Neonate: 400 ml

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6
Q

Prime:
adult prime
Neonate prime

A

Adult: 1.5 L (25% dilution)
Neonate: 500mL (125% dilution)

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7
Q

Prime:

what is the prime made up of?

A
  • plasmalyte (1000mL or less)
  • Albumin (200mL 25% 50G) for COP (avoid edema) and coating of circuit
  • Heparin 1000-10000 Units
  • Ca++ 300-700mg
  • Blood
  • FFP
  • Bicarb (25-50mEq) and/or THAM
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8
Q

Prime:

what is the crystaloid of choice

A

Plasmalyte

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9
Q

Prime:

blood is usually added if predicted HCT is what?

A

<16

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10
Q

Ultrafiltration:

what are the 3 types

A

PBUF (Pre-bypass Ultrafiltration)
ZBUF (Zero Balance Ultrafiltration)
MUF (modified Ultrafiltration)

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11
Q

Cardioplegia:

what is it used for?

A
  • arrest the heart so surgeon can have a bloodless field (this fag bag talks way too much about making the god damn surgeon happy, it like the fagget has no balls)
  • Preserve the tissue
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12
Q

Cardioplegia:

what must you worry about following termination of cardioplegia?

A

reperfusion injury

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13
Q

Cardioplegia:

Myocardial O2 demand drops ___% for every 10 degrees celsius of cooling?

A

50%

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14
Q

Cardioplegia:

Body O2 demand drops 50% for every ___ degrees celsius of cooling?

A

6

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15
Q

CARDIOPLEGIA:

what are the ingredients

A 
Blood (4-1)
K+ (20 mEq/L)
Adenosine
Mannitol/Albumin
Glucose-insulin
Glutamate/Aspirtate (buckberg AA )
Steroids
CCB
CA chelator (CPD)
Allopurinol
Buffers
Lidocaine/Mg++
O2
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16
Q

CARDIOPLEGIA:

what type of blood is best used?

A

Leukocyte depleted

17
Q

CARDIOPLEGIA:

how much K+ is used?

A

20 mEq/L

18
Q

CARDIOPLEGIA:

why is mannitol/albumin used?

A

osmolarity

19
Q

CARDIOPLEGIA:

what CCB is usually used?

A

diltazem

20
Q

CARDIOPLEGIA:

why is allopurinal used?

A

O2 free radical scavengers

21
Q

CARDIOPLEGIA:

what are buffers used?

A

Bicarb

THAM

22
Q

CARDIOPLEGIA:

why is lidocaine/Mg++ used?

A

membrane stabilization

23
Q

CARDIOPLEGIA:

some studies have shown that uses what blood shown benefits? Arterial or Veneous?

A

Venous

24
Q

Bypass causes what throughout the body?

A

Systemic Inflammatory response

25
Q

CPB inflammatory response:

Material dependent causes?

A
  • exposure of blood to non-physiologicl surfaces (PVC tubing)
  • exposure of blood to non-physiological conditions (blood-air interface
26
Q

CPB inflammatory response:

Material independent cause?

A
  • surgical trauma
  • ischemia-reperfusion of organs
  • changes in body temp
  • release of endotoxin
27
Q

CPB inflammatory response: (SIRS)

Complications

A 
leukocytosis
Histamine release (from C3a/C5a)
Increased capillary permeability
Accumulation of interstitial fluid
Organ dysfunction (primarily Lungs)
late depression of inflammatory response (day 5)
28
Q

How to prevent SIRS

A 
coated circuit
puslsatile perfusion
Leukocyte depleted filters (rewarming)
continuous blood flow to lungs
Eliminate blood Air interface
use of a hemoconcentrator (washed cells)
Meds 
-preop steroids
-aprotinin
-CCB
-IIb, IIIa platelet blockers
Viagra
29
Q

Complications of perfusion

A 
blood exposure
pulmonary
renal
Neuro
major organ hypoperfusion
Bleeding
infection
Cardiac
length of stay
30
Q

ECMO:

2 types of partial support

A

Veno Veno

Veno Arterial

31
Q

I duno thats it i guess!!!!!

A

this was a shitty lecture

Principles III (24 decks)

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