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Perfusion Technology Flashcards

1
Q

“Perfusion” a french word means?

A

Pour over or through

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2
Q

Contractions of the heart generate blood pressure, which is responsible for moving blood through the blood vessels.

[functions of heart]

A

Generating blood pressure

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3
Q

The heart separates the pulmonary and systemic circulations and ensures better oxygenation of the blood flowing to the tissues.

[functions of heart]

A

Routing blood

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4
Q

The valves of the heart ensure a one-way flow of blood through the heart.

[functions of heart]

A

Ensuring one-way blood flow

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5
Q

[5] Route of blood flow - Deoxygenated blood

[SRR, PP]

A
  1. Superior vena cava
  2. Right atrium
  3. Right ventricle
  4. Pulmonary trunk
  5. Pulmonary arteries
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6
Q

[5] Route of blood flow - Oxygenated blood

[PLL, AC]

A
  1. Pulmonary veins
  2. Left atrium
  3. Left ventricle
  4. Aorta
  5. Coronary arteries
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7
Q

A skilled, allied health professional, trained and educated specifically as a member of an open heart, surgical team responsible for the selection, setup, and operation of a mechanical device commonly referred to as the heart-lung machine.

A

Perfusionist

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8
Q

It is needed to attach organ to sterile tubings.

A

Cannula

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9
Q

(He) Development of a roller pump in the 1930’s led to the first successful extracorporeal assist in 1953.

A

Dr. John Gibbon

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10
Q

Revolutionized the artificial lung with the development of synthesis of silicone rubber.

[name]

A

Kammermeyer

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11
Q

Developed an approach to continuously titrate coagulation with Heparin.

[name]

A

Bartlett and drinker

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12
Q

Reported the first successful cardiac ECMO run of 36 hours in a 2-year-old infant with cardiac failure.

[name]

A

Bartlett, Gazzaniga et. al

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13
Q

Provides a bloodless field for cardiac surgery.

A

Cardiopulmonary bypass (CPB)

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14
Q

It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump.

A

Cardiopulmonary bypass (CPB)

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15
Q

[2] Pump

A
  1. Roller pump
  2. Centrifugal pump
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16
Q

Includes two rollers positioned on a rotating arm, which compress a length of tubing to produce forward flow.

[pump]

A

Roller pump

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17
Q

It consists of impellers/stacked cones within housing.

[pump]

A

Centrifugal pump

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18
Q

It may improve platelet preservation, renal function and neurological outcomes in longer cases.

[pump]

A

Centrifugal pump

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19
Q

It connect the patient to the circuit and hence to the CPB machine.

A

Cannulae

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20
Q

[2] Cannulae

A
  1. Venous cannulae
  2. Dual stage cannulae
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21
Q

Single-stage cannulae are used during most open-heart surgeries, where two cannulae are inserted into the superior and inferior vena cava and joined by a Y-piece.

[cannulae]

A

Venous cannulae

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22
Q

Used for most closed-heart procedures, where ba single cannula is inserted into the right atrium.

[cannulae]

A

Dual-stage cannulae

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23
Q

[2] Oxygenator

A
  1. Bubble oxygenators
  2. Membrane oxygenators
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24
Q

Largely of historical interest in the era of membrane oxygenators.

[oxygenators]

A

Bubble oxygenators

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25
Q

Consist of hollow microporous polypropylene fibres (100–200 μm internal diameter).

[oxygenators]

A

Membrane oxygenators

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26
Q

These are generally made of PVC, due to PVC’s durability and acceptable haemolysis rate.

A

Tubing

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27
Q

They collect the blood drained from the heart.

A

Reservoirs

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28
Q

[2] Types of reservoirs.

A
  1. Open reservoirs
  2. Close reservoirs
29
Q

More commonly used.

[reservoirs]

A

Open reservoirs

30
Q

They allow passive removal of entrained venous air along with the option of applying vacuum to assist drainage.

[reservoirs]

A

Open reservoirs

31
Q

Have a limited volume capacity, but offer a smaller area of blood contact with artificial surfaces.

[reservoirs]

A

Closed reservoirs

32
Q

This produces less inflammatory activation (lesser contact with foreign antigens), better sterility and reduces postoperative transfusion.

[reservoirs]

A

Closed reservoirs

33
Q

They, however, require a separate circuit for processing suctioned blood.

[reservoirs]

A

Closed reservoirs

34
Q

It is a method of myocardial protection where the heart is perfused with a solution to cause electromechanical arrest which reduces myocardial oxygen consumption.

A

Cardioplegia system

35
Q

It is inserted proximally while the aortic cannula is distal to the clamp.

A

Cardioplegia cannula

36
Q

[3] Mechanical Complications

[AVO]

A
  1. Arterial complications
  2. Venous complications
  3. Other complications
37
Q

Cannulation can be associated with bleeding, cannula malposition causing selective cerebral perfusion, plaque dislodgement and dissection.

[mechanical complications]

A

Arterial cannulation

38
Q

Cannulation can be associated with bleeding, cannula malposition/air lock causing an inadequate return, leading to cerebral and splanchnic congestion.

[mechanical complications]

A

Venous complication

39
Q

[2] Complications

A
  1. Mechanical
  2. Systemic
40
Q

CPB causes qualitative and quantitative platelet dysfunction.

[complication]

A

Systemic complication

41
Q

It can occur due to cross clamping of the aorta in spite of cardioplegia.

[systemic complication]

A

Subclinical myocardial injury

42
Q

They employ artificial blood pumps to propel open-heart surgery patients’ blood through their body tissue, replacing the function of the heart while the cardiac surgeon operates.

A

Perfusionists

43
Q

The rate and force of heart contractions change to meet the metabolic needs of the tissues, which vary depending on such conditions as rest, exercise, and changes in body position.

A

Regulating blood supply

44
Q

[4] Functions of the heart

A
  1. Generating blood pressure
  2. Routing blood
  3. Ensuring one way blood flow
  4. Regulating blood supply
45
Q

It may improve platelet preservation, renal function and neurological outcomes in longer cases.

[pump

A

Centrifugal pump

46
Q

This action can produce haemolysis and tubing debris, the incidence of which increases with time.

[pump]

A

Roller pump

47
Q

They are made of polyvinylchloride (PVC) and are wire reinforced to prevent obstruction due to kinking.

48
Q

Calculations are performed to determine necessary blood flow and if blood or other products are needed.

[conduct of cardiopulmonary bypass]

A

Pre-bypass

49
Q

The deairing of CPB circuit is done by priming solutions, consisting of a mixture of crystalloids and colloids.

[conduct of cardiopulmonary bypass]

50
Q

It causes haemodilution which improves flows during hypothermia. Heparin 3–4 units/ml is added to the prime.

[conduct of cardiopulmonary bypass]

51
Q

During arterial cannulation, systolic pressure should be?

[initiation]

A

90–100 mm Hg

52
Q

Perfusion pressure is used as a surrogate marker of organ perfusion and should be maintained between 50 and 70 mmHg.

[conduct of cardiopulmonary bypass]

A

Anesthesia and monitoring on CPB

53
Q

It can cause inflammatory response and hypotension.

A

Acute kidney injury (AKI)

54
Q

Inflammatory response and hypotension can cause acute kidney injury (AKI). Risk factors are prolonged bypass time, sepsis and diabetes.

[complication]

A

Systemic complications

55
Q

The spectrum of cerebral injury ranges from cognitive dysfunction to stroke.

[complications]

A

Systemic complications

56
Q

A broader term used synonymously, both include various modalities of temporary mechanical cardiopulmonary assistance used to support patients with severe heart and/or lung failure which is unresponsive to optimal conventional care.

A

Extracorporeal Membrane Oxygenation (ECMO) and Extracorporeal Life Support (ECLS)

57
Q

Safe temperature margin:

[temperature management]

A

28 to 30 C

58
Q

Calculations are performed to determine necessary blood flow and if blood or other products are needed.

[conduct of cardiopulmonary bypass]

A

Pre-bypass

59
Q

The deairing of CPB circuit is done by priming solutions, consisting of a mixture of crystalloids and colloids.

[conduct of cardiopulmonary bypass]

60
Q

Causes haemodilution which improves flows during hypothermia. Heparin 3–4 units/ml is added to the prime.

[conduct of cardiopulmonary bypass]

61
Q

During arterial cannulation, systolic pressure should be 90–100 mm Hg to reduce the risk of aortic dissection.

[conduct of cardiopulmonary bypass]

A

Initiation

62
Q

Perfusion pressure is used as a surrogate marker of organ perfusion and should be maintained between 50 and 70 mmHg.

[conduct of cardiopulmonary bypass]

A

Anesthesia and Monitoring on CPB

63
Q

Hypertensive patients and those at risk for stroke require higher flows and perfusion pressures to maintain organ perfusion.

[conduct of cardiopulmonary bypass]

A

Anesthesia and Monitoring CPB

64
Q

Blood level in the reservoir should be monitored to prevent air embolism.

[conduct of cardiopulmonary bypass]

A

Anesthesia and Monitoring of CPB

65
Q

Central venous pressure (CVP) should be low. High CVP indicates a poor venous return.

[conduct of cardiopulmonary bypass]

A

Anesthesia and Monitoring of CPB

66
Q

Hypothermia is frequently used during CPB for its presumed organ protective effects.

[conduct of cardiopulmonary bypass]

A

Temperature Management

67
Q

Blood viscosity increases with hypothermia and allows maintenance of a higher perfusion pressure despite haemodilution.

[conduct of cardiopulmonary bypass]

A

Temperature Management

68
Q

Normothermic bypass: less platelet dysfunction and higher blood flow which increases trauma.

[conduct of cardiopulmonary bypass]

A

Temperature management

69
Q

During and after CPB removes inflammatory mediators and excess fluid thereby producing haemoconcentration.

[conduct of cardiopulmonary bypass]

A

Ultrafiltration

SPDX 311 (12 decks)

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