Topic 4 - Review of CPB Flashcards Preview

Perf Tech II (exam 1) > Topic 4 - Review of CPB > Flashcards

Flashcards in Topic 4 - Review of CPB Deck (23):
1

Surgeon remove clamp in arterial cannula next you...?

Check for pulsations to make sure there is adequate line pressure and pulsations

2

Asked to do a test transfusion means you?

make sure that the cannula is in fact in the aorta and not in a false lumen
-if pressure risees greatly during the test transfusion (check cannula placement/position)

3

order of cannulations?

arterial cannulation
venous cannulation
retrograde cadioplegia cannula placed

4

Going on bypass first start ...

-Arterial pump (give a little preload)
-Remove clamp from venous line (make sure level rises)

5

While you are turning up arterial pump head to get to full flow when starting bypass you do what?

-Open shunts
-Turn on gas flow
-start your timers "on bypass at.."
-get to full flow "at full flow"
- anesthesia stops ventilating

6

Getting ready for AoXC placement

turn down flow
make sure CPG line is filled/clear of bubbles
cool to desired systemic temperature

7

After the AoXC is on - what is given?

-Cardioplegia "Start cardioplegia"
-Watch delivery pressures (start slow)

this is the beginning of the ischemic time of the heart

8

MAP on bypass

80-85mmHg gives better neurological outcomes

9

SVO2 on bypass

>70%
if it lowers oxygen consumption could be increasing which means maybe pt waking up - consult anesthesia

10

U.O. on bypass

should be between .5-1mls/kg/hr

11

Normothermia pressure range for proper organ function?

80-100mmHg

12

Decreased perfusion pressurse of 50-60mmHg cause

cerebral injury and kidney function reduced

13

Increased perfusion pressures of >100mmHg causes?

-increased intracranial pressures
-excessive blood return to heart
-fluid shifts create edema
- increased SVR may decrease tissue perfusion

14

Pediatric Flow rate

80 - 100mls/min/kg

2.4-2.8 L/min/m2

15

Neonate

120-150mls/min/kg

3.0-3.4 L/min/m2

16

Adult

60-70mls/min/kg

2.2-2.6 L/min/m2

17

Cross clamp drugs

lidocaine, mannitol and magnesium sulfate

18

Surgical correction complete and Surgeon intrusts flow down - what will happen next?

Surgeon will remove the AoXC

19

"Cross clamp is off" - what do you do, and than what is placed?

come back on flow gradually
- watch pressures
Temporary pacemaker is placed (usually)

20

Final checks - make sure K is acceptable

k of 5.0mEq/L is accepatable
K will drop about 1.0mEq/L in the immediate post CPB period

21

Surgeon says come for to 1/2 flow and stay there - what do you do?

-Clamp the venous line partially
-Fill patient
-Come down on flow slowly to desired filling pressure number
-Adjust clamp on venous lone accordingly

22

chasing the circuit

transfuse most of the pump blood in the reservoir. add crystalliod to the reservoir, which will keep the circuit primed while displacing all good pump blood back to patient

23

Once protamine is given and pt stable surgeon will...

decannulate