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Related Flashcards
Cards In This Set
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What is "step 1" of CPB?
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Turn on the oxygenator! (And make sure you have good color difference.)
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In order to not hemodilute the patient, what do we do?
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Try to keep priming volume as low as possible, keep lines shorter, and use the appropriate lines to create the circuit.
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Which line is always bigger in size, venous or arterial?
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Venous line
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What type of tubing is used with cell savers but not heart lung machines and why?
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Silicone - because it is very soft and not as strong as PVC, Polyurethane or Super Tygon, which can cause spallation (little shards will pop out into blood) and can rupture tubing and will quickly have to come off bypass.
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What are the tubing sizes/prime volume per foot?
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1/2 inch/39 cc per foot
3/8 inch/22 cc per foot
1/4 inch/10 cc per foot
(all are 3/32 inch thickness)
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Whats the difference between an "open" and "closed" type venous reservoir?
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"open" types are rigid (hard) plastic canisters and air rises to the top whereas "closed" types are soft, collapsible plastic bags with no air interface
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What is the max negative pressure level you should not exceed with the vacuum assist?
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-30 mmHg
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What is the "venturi effect"?
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The reduction in fluid pressure that results when a fluid flows through a constricted section of pipe - in other words it pulls air in and can cause an air embolism.
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What performance characteristics do we look for in tubing?
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Memory
elasticity
durometer
clarity/transparency
inert
tolerant of heat sterilization
biocompatibility
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What 4 locations can an arterial cannula be placed?
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Ascending aorta
femoral artery
axillary subclavian artery
innominate artery
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What are the advantages of using an axillary subclavian artery for cannulation?
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1) freedom from atherosclerosis
2) antegrade flow into the arch vessels
3) protection of the arm and hand by collateral flow
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What does "Total CPB" and/or "Tapes Down" mean?
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ALL blood is diverted to bypass.
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If you have negative pressure on a cannula and the vessel is sucked down/clamped down around it, if you increase the vacuum what will happen?
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Nothing - because you need to reduce the vacuum to release the clamping down.
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What are some complications associated with venous cannulation?
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> atrial arrythmias
> atrial or caval tears and bleeding
> air embolism
> injury or obstruction (due to catheter malposition, reversing arterial and venious lines, and unexpected decannulation)
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What is the function of vents?
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To prevent distention of the cardiac chambers and provide adequate surgical exposure (for the surgeon to see his/her field better)
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