Neonatal & Pediatric Perfusion Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Neonatal & Pediatric Perfusion flashcards as text
A neonate with a single-ventricle physiology pre-Fontan palliation has an oxygen saturation of 75% on room air. This most likely reflects:
Answer: Expected mixing physiology with balanced pulmonary and systemic flow
Single-ventricle mixing physiology inherently produces systemic saturations in the 75–85% range when pulmonary and systemic blood flows are balanced.
During neonatal CPB, what is the primary rationale for using a membrane oxygenator rather than a bubble oxygenator?
Answer: Reduced microemboli and less blood trauma
Membrane oxygenators generate significantly fewer gaseous microemboli and cause less blood trauma compared to bubble oxygenators, which is critical in neonates.
Which parameter best guides the perfusionist in determining the adequacy of systemic oxygen delivery during neonatal hypothermic CPB?
Answer: Mixed venous oxygen saturation (SvO2)
SvO2 reflects the balance between oxygen delivery and consumption; a value above 65–70% indicates adequate systemic oxygen delivery during CPB.
In a 3.5 kg neonate, the standard initial heparin dose before CPB is approximately:
Answer: 300–400 units/kg
Neonates receive 300–400 units/kg of heparin before CPB to achieve an ACT greater than 400–480 seconds required for safe anticoagulation.
Which circuit component modification is most critical when assembling a neonatal CPB circuit to minimize prime volume?
Answer: Using small-diameter tubing (3/16" or 1/4")
Smaller diameter tubing dramatically reduces circuit prime volume, which is essential to minimize hemodilution in small neonates whose blood volume may be less than 250 mL.
A pediatric patient post-CPB develops persistent pulmonary hypertension unresponsive to oxygen and hyperventilation. The most appropriate pharmacologic intervention is:
Answer: Inhaled nitric oxide (iNO)
Inhaled nitric oxide selectively dilates pulmonary vasculature without causing systemic hypotension and is the first-line therapy for refractory pulmonary hypertension post-CPB.
During the Norwood Stage I procedure for HLHS, the perfusionist's primary concern during rewarming after DHCA is:
Answer: Preventing cerebral hyperthermia by limiting rewarming rate
Rapid rewarming after DHCA can cause cerebral hyperthermia and worsen neurological injury; rewarming should be gradual with temperature gradients less than 10°C.