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Flashcards in Perfusion Circuit Deck (19)
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1
Q

What is a perfusion circuit

A
  • designed to provide a bloodless and motionless field for the surgeons to work
  • safe and simple are best
2
Q

open system has what kind of reservoir

A

hard shell

3
Q

closed system has what type of reservoir

A

soft/bag venous reservoirs

4
Q

details of open system

A
  • hard shell reservoir
  • vented to room air, blood in direct contact with air
  • most contain cardiotomy with filter
  • can be used alone or with additional cardiotomy reservoir
5
Q

details of closed system

A
  • bag venous reservoir
  • made of PVC
  • blood has no direct contact with air
  • no cardiotomy or filter - must use external cardiotomy reservoir
  • must be able to remove air from bag
6
Q

adult circuits

A
  • adult oxygenators have larger surface areas allowing for high flows and gas transfer
  • flow rates up to 7L
  • 3/8” to 1/2” venous lines inside lumen
  • 3/8” arterial line
7
Q

ped/infant circuits

A
  • small oxygenators w/ low priming volumes, smaller surface areas for gas transfer
  • 3/16”, 1/4”, 3/8” venous lines
  • 1/8”, 3/16”, 1/4” arterial lines
8
Q

suction systems

A
  • suction lines
  • suction tips: general and vent or sump
  • suction blood drains directly into hard shell reservoir or via cardiotomy reservoir into softshell reservoir bag
9
Q

blood cardioplegia delivery system

A

-used for myocardial protection
-integral heat exchanger
-various solutions used
-buckberg and del nido solutions used @CHI
various blood/crystalloid doses (4:1, 1:4)
various delivery methods
various temp

10
Q

safety features of perfusion circuits

A
  • response time
  • alarms
  • servoregulation
11
Q

response time

A

to not drain reservoir
-also includes: bubble detector and level sensor alarms, loss of venous return/level, high pressure in perfusion circuit, loss of power

12
Q

servoregulation

A

set to decrease flow as level and/or pressure approaches or exceeds settings

13
Q

circuit design consideration

A
  • type of pump
  • oxygenator system size and type
  • cardiotomy reservoir
  • suction system
  • line diameter, length, AV loop
  • surgeon procedure considerations
  • assisted venous drainage
14
Q

arterial line filter

A
  • filter particulates air emboli and microemboli
  • purge line with one way valve
  • bypass line
  • micron size
  • integrated in membrane or external filters
15
Q

gas line

A
  • from blendor to oxygenator
  • 0.2 micron filter
  • 1/4” green tubing
  • oxygen analyzer
  • isoflurane vaporizer
16
Q

manifold system

A

system of stopcocks joined with lines from v inlet and a inlet outlet

  • arterial side has one way valve
  • blood sampling and drug administration
17
Q

cardioplegia delivery system

A
  • custom or off the shelf
  • integral heat exchanger or bucket of ice
  • delivers a solution per surgeon preference
  • delivers various ratio of CPG to blood based on institution
  • temperature probe site
18
Q

oxygenators

A
  • rated flows dependent on surface area
  • oxygenation and CO2 removal considerations depending on patient body surface area
  • integrated heat exchanger
19
Q

how much times does it take to drain your venous return during CPB

A

level of 1000mL
flow of 4000 mL/min
seconds to drain = reservoir level x 60/ flow mL/min
1000x60/4000 = 15 seconds