CCP Intraoperative Procedures & Patient Monitoring 2

Question 1

During cardiopulmonary bypass, which parameter best reflects cerebral oxygen delivery adequacy when using near-infrared spectroscopy (NIRS)?

Accepted Answer

Regional cerebral oxygen saturation (rSO2) >50% of baseline

Answer

NIRS-derived rSO2 dropping below 50% of the patient's baseline value is the accepted threshold indicating inadequate cerebral oxygen delivery.

Question 2

A patient on CPB develops sudden onset of bright red arterial line blood and a marked increase in arterial line pressure. The most likely cause is:

Accepted Answer

Aortic dissection

Answer

Sudden bright red blood in the arterial line combined with a pressure spike suggests aortic dissection, where the cannula tip has entered the false lumen.

Question 3

Which of the following is the primary purpose of administering mannitol during cardiopulmonary bypass?

Accepted Answer

Promote osmotic diuresis and free radical scavenging

Answer

Mannitol is used during CPB as an osmotic diuretic to maintain urine output and as a free radical scavenger to reduce reperfusion injury.

Question 4

During rewarming on CPB, the maximum recommended temperature gradient between the heat exchanger water and the patient's blood temperature is:

Accepted Answer

10°C

Answer

A water-to-blood temperature gradient exceeding 10°C risks gas coming out of solution and forming emboli in the blood.

Question 5

The activated clotting time (ACT) target for full heparinization during cardiopulmonary bypass is generally:

Accepted Answer

>400 seconds

Answer

Most centers target an ACT greater than 400 seconds (some use 480 seconds) before initiating CPB to prevent clot formation in the circuit.

(CCP) Certified Clinical Perfusionist Practice Test

(CCP) Certified Clinical Perfusionist Practice Test

CCP Intraoperative Procedures & Patient Monitoring 2