Blue M2 Flashcards
At what temp will the coagulation system have a significant reduction in function?
< 33 degrees
EBV
Males Wx7,5%
Females Wx7%
BSA
Body surface area
(H+W-60)/100
EBF
Estimated blood flow
2,4xBSA
Hct2
(Hct1 x EBV) / (EBV + PrV)
Cooling gradients
V-A 5 degrees C
V-W 8-10 degrees C
Warming gradient
10 degrees or less
Crash cooling
- Initiate at patient temperature
- HCU to 3-15 degrees
- Arterial line never under 10 degrees
- moderate tp when close to desired tp
At which temperature does the coagulation system become completely ineffective
18-25 degrees
At which temperature does the coagulation system start to become inefficient
< 33 degrees
Normal APTT
30-50 sek
When can’t APTT be used
When there is a high heparin does (on bypass)
What affects ACT
- Temperature (low temp will make ACT go up)
- Plt
- Hemodilution
What kind of cannulas for a surgery where you have to open on the right side of the heart?
Bi caval (2 single stage catheters)
Which way does the O2 dissociation curve shift to when the patient has acidosis?
Curves shifts to the right
Acidosis pH lower than 7,35
What should the DO2 be?
Min. 280-300 ml/min/m2
What should MAP be at?
50-80 mmHg
Normal cl-
What can a high cl- lead to?
98-108
Hyperchloremic acidosis
What is hypercloremic acidosis
A type of metabolic acidosis where a high chloride reduce bicarbonate lvl.
Low ph is?
Acidosis
High ph
Alkalosis
Normal BE?
-2 - +2
Normal HCO3-
22-26mmol
Normal PaO2
10-13,3kpa
Normal PaCO2
4.7-6kpa
Correlation between pH and CO2
(Low/high)
High pH = low CO2 (alkaloses)
Low pH = high CO2 (acidosis)
When the patient gets cold what happens to the ph and co2
The patient gets alkaloses - and ph will rise and co2 will decrease
When you cool the patient what happens with ph, co2 and dissociation curve?
pH goes up (alkaloses), CO2 goes down, dissociation curve shifts left!
Explain oxy-hb dissociation curve
Left shift (high pH, low CO2) oxygen binds more strongly to hb, and vice versa with a right shift
Normal LVEF
50-70%
When is LVEF a concern?
Under 50% - cardiac dysfunction or heart failure
Under 35% - significant reduction
