cannula malposition

Question 1

1) The patient in this article was 90 kg. The article states that the goal flow rate for antegrade cerebral perfusion using an independent roller pump was 10-12 ml/kg/min. What is the desired flow range for this patient?

Answer 1

90kg x 10/12 = 900-1080 ml/min

Question 2

2) The unresponsive right rSO2 plus the excessive increase in right radial pressure suggested that the tip of the right catheter used for cerebral perfusion might have been placed within the

Answer 2

Right subclavian artery__.

Question 3

3) This institution prefers to cannulate the innominate artery rather than the right common carotid artery. List 3 reasons why they prefer this. (1 point each)

Answer 3

1. It is more difficult to cannulate
2. The deeper carotid artery; vessels closer to the cranium are more fragile and harder to repair if a tear should occur
3. Cannulation of the innominate artery allows perfusion of the right vertebral artery and right arm.

Question 4

4) Incompleteness of the Circle of Willis due to missing anterior or left posterior communicating arteries occurs in _____% of the population.

Answer 4

20-30%

Question 5

Unlike pulse oximetry, cerebral oximetry does NOT require blood pulsatility.

Answer 5

True

Question 6

6) In the study by Murkin et al they used a decrease in cerebral oximetry of >____% from baseline as an indicator of increased ischemic risk

Answer 6

25%

Question 7

7) Fischer et al found that patients whose rSO2 was under the absolute threshold of ___% for more than 30 minutes while undergoing aortic arch repair had an extended hospital stay or __ days.

Answer 7

60%/4 days

Question 8

8) This study states that cerebral desaturation is common with a reported incidence of up to __% during CPB.

Answer 8

50%