ABG Management

Question 1

Hb <70 g/L

Answer 1

1. Increase urine output
2. Add filtration device
3. Request blood transfusion

Question 2

Hb >70 g/L

Answer 2

Consult anaesthetist. Polycythaemia -consider preserving blood to reduce RBC damage- (pre op or peri op).

Question 3

ACT <480

Answer 3

Addition of heparin as per protocol (at least 5KU)

Question 4

pH < 7.35-7.45

Answer 4

1. Increase pump flow
2. Increase gas flow
3. Consider 8.4% NaHC03

Question 5

pH > 7.35-7.45

Answer 5

1. Decrease pump flow 2. Decrease gas flow

Question 6

pO2 < 25-65 kPa

Answer 6

1. Increase FiO2

2. Increase arterial flow 3. Blood transfusion if Hb low

Question 7

pO2 > 25-65 kPa

Answer 7

1. Decrease FiO2

2. Increase temp

Question 8

pCO2 < 4.5-6.5 kPa

Answer 8

1. Decrease gas flow

2. Increase temp

Question 9

pCO2 > 4.5-6.5 kPa

Answer 9

1. Check CO2 flooding
2. Increase gas flow
3. Increase arterial flow

Question 10

Base Deficit < -5

Answer 10

1. Increase pump flow 2. Administer 8.4% HCO3

Question 11

Base Deficit > -5

Answer 11

Consult Anaesthetist

Question 12

K+ < 4.5-5.5mmol

Answer 12

1. < 4.0 add KCl 10 mmols & re check

2. Consult anaesthetist

Question 13

K+ > 4.5-5.5mmol

Answer 13

1. KCl > 5.5 increase urine output

2. Consult anaesthetist

Question 14

Urine output <1ml/kg/hr

Answer 14

1. Ensure MAP within normal CPB range
2. Mannitol 10%
3. Increase blood flow
4. Furosemide

Question 15

MAP < 60-85 mmHg

Answer 15

1. 0.5mg Metaraminol
2. Increase arterial flow
3. Consult Anaesthetist

Question 16

MAP > 60-85 mmHg

Answer 16

1. Reduce flow if possible 2. 0.5 mg Phentolamine 3. Consult Anaesthetist

Question 17

CVP < -5 to +5

Answer 17

1. Check line for air entrainment

2. Re-zero transducer

Question 18

CVP > -5 to +5

Answer 18

1. Check cannula & tubing (kinks)
2. Awareness of heart position
3. Re zero transducer
4. Consider VAVD
5. Elevate table or lower reservoir

Question 19

SaO2 < 100%

Answer 19

1. Increase FiO2
2. Increase arterial flow
3. Increase Hb

Question 20

SvO2 < 65% (target 65% +)

Answer 20

1. increase oxygen delivery (flow, FiO2, Hb)

Question 21

SvO2 > 65% (target 65% +)

Answer 21

1. Repeat Venous gas to check
2. Check for shunt
3. Check temp
4. Check flow rate calculations

Question 22

Cerebral Oximetry monitoring (below range)

Answer 22

1. Increase arterial flow / is blood pressure in agreed range
2. Increase pCO2
3. Raise Hb
4. Reduce temperature

Question 23

Glucose < 4.5 - 8.0 mmol

Answer 23

1. Consult Anaesthetist

Question 24

Glucose > 4.5 - 8.0 mmol

Answer 24

1. Consult Anaesthetist
2. Beware of Glucose increase post hot
   shot

Question 25

Lactate > 0.5 - 1.6 mmol

Answer 25

1. Consult Anaesthetist

Question 26

Lactate < 0.5 - 1.6 mmol

Answer 26

1. Increase pump flow 2. Correct PCO2

3. Administer 8.4% NaHCO3 if acidotic