CPB

Question 1

what is in the priming fluid

Answer 1

heparin, mannitol, NaHcO3, albumin, corticosteroids, abx

Question 2

where are sites that can be cannulated for ecmo

Answer 2

aorta, femoral,. axiallary

Question 3

flow from patient to cannula

Answer 3

venous line - reservior - arterial pump - oxygenator/heat exchanger - arterial line -aorta

Question 4

difference between an alpha stat and pH stat

Answer 4

alpha is commonly used. its NOT temperature corrected. CO2 is kept constant.

pH: typically used for peds and adults for circulatory arrest

temperature corrects blood gas values, allows for build up for CO2 and R shift on the oxyhgb curve

Question 5

how is metabolism linked with cooling

what are the negatives of cooling

Answer 5

Q10 principle every 10 degree drop is 50% decrease in metabolism

higher blood viscocity, coagulopathy, dysrythmias, third spacing

Question 6

how quickly can you rewarm a patient from CPB

Answer 6

1 degree eveything 5 min

Question 7

when waking up, what is CVP meaning

Answer 7

C: coagulation, conduction, cardiac output, calcium, cells,

V: visualization, ventilation, vaporization, volume

P: predictors, pressors, pressure, pacing, potassium protamine,

Question 8

what are some blood conserving methods

Answer 8

minimize cooling, minimize priming fluid, hemoconcentrate, replace fluids with colloids or blood, give TXA, use cell saver

Question 9

what are safe arrest time correlated to temperature

Answer 9

32 degrees - 10 min

28 - 10 to 15 min

18 - 16 to 45 min

<18 45 to 60 min

Question 10

what are the three takes offs from the aorta

Answer 10

1. brachiocephalic/innominate - splits into the R common carotid and R subclavian
2. Left common carotid
3. Left subclavian

Question 11

VA ecmo vs VV

why would this be used instead of CPB

Answer 11

VA= heart and lung

VV = lung

longer time on the machine in the ICU

Question 12

LVAD and intraaortic balloon pump

discuss

Answer 12

baloon pump: inflates during diastole and deflates during systole