Cardiac

Question 1

Heparin Resistance Cause? Treatment?

Answer 1

Antithrombin 3 deficiency. Give FFP

Question 2

Type 3 protamine reaction pathophysiology?

Answer 2

Protamine-Heparin Complex induced release of Thromboxane A2 leading to increased PA pressures and decreased RV systolic function

Question 3

Centrifugal vs Roller pumps?

Answer 3

Roller: Not Sensitive to Preload/Afterload, pulsatile Flow, RBC damage, Microscopic bubbles, Large quantities of air if air entrained in pump

Centrifugal: No pulsatile flow. Sensitive to preload/afterload. Will stop if too much entrained air

Question 4

pH Stat vs Alpha Stat:

Answer 4

pH Stat: Higher cerebral blood flow as CO2 is added to ensure paCO2 of 40.
Alpha Stat: Alkaline drift with respiratory alkalosis.

Question 5

ACT needed for heparinization?

Answer 5

ACT > 480