Flashcards in Cardiopulmonary Bypass Deck (28):
Why bypass the heart and lungs? For _____ heart procedures, ________ that do not tolerate mechanical manipulation, ______, distal ___________.
Open heart procedures
Distal airway reconstruction
How to bypass the heart and lungs?
1 drain venous blood
2 collect in reservoir
3 pump it through a device
4 oxygenate and filter
5 return via aorta
What are the components of CPB?
What are two kinds of biosurface?
Terumo and Medtronic
Terumo is an X-coating (what does this mean?) which is ______ and ______. It ______ protein desaturation and platelet adhesion.
Amphiphilic and biopassive
Three kinds of Medtronic biosurface?
Which Medtronic biosurface is not heparin coated?
Which Medtronic biosurface are hydrophilic?
Which Medtronic is negatively charged?
Which Medtronic is nonleaching?
The hard shell reservoir has
Stable blood levels
High visibility scale
The Levelsens is a ______ reservoir with
Low level alarm
Review the centrifugal pump cause the pictures I printed are too small to read
Go do that
Review the membrane lung vs natural lung chart
Fill this in later...
Anticoagulation is achieved through ______ at _____ units per kg. the activated clotting time (ACT) is
Unfractionated heparin (UFH)
The HMS Medtronic Plus uses ______ heparin concentration based anticoagulation with heparin _______ and automated ______ titration
Heparin dose response
Automated protamine titration
What is monitored on CPB?
CO, SVO2, SVR
Arterial blood gases
What is the equation for SVR?
SVR = (MAP-CVP)/CO
Arterial blood gases on the CPB are monitored every
What factors contribute to myocardial protection?
Pre CPB stable hemodynamics
Adequate cardioplegia (intentional and temporary cessation of cardiac function)
Weaning from CPB
Confirmed by echocardiologist
De aired heart
Appropriate ABG, gas exchange, electrolytes
What needs to be done post CPB?
Protamine to reverse UFH
Follow up hematology studies
How does protamine reverse UFH?
Binds to it to form a stable ion pair that does not have anticoagulant properties
What are the follow up hematology studies?
PT/INR/PTT, fibrinogen, thrombin time
Complications of CPB?
Cardiovascular collapse - graft failure, thrombosis, coronary spasm, residual defects, L/R heart failure, dysrhythmias
Rapid cardiopulmonary support (CPS)