CCP Neonatal & Pediatric Perfusion 3

Question 1

A 4 kg infant on CPB has a hematocrit of 18%. The most appropriate perfusionist action is:

Accepted Answer

Transfuse packed red blood cells into the circuit

Answer

A hematocrit below 20–24% in neonates warrants PRBC transfusion to ensure adequate oxygen-carrying capacity during hypothermic CPB.

Question 2

Which anatomical characteristic of the neonatal coronary circulation most influences cardioplegia delivery technique?

Accepted Answer

High coronary-to-aorta flow ratio requiring lower delivery pressures

Answer

Neonatal coronary vessels are small and have high flow relative to aortic pressure, so cardioplegia should be delivered at lower pressures (40–60 mmHg) to avoid barotrauma.

Question 3

During pediatric CPB, cerebral near-infrared spectroscopy (NIRS) shows a drop in rSO2 from 72% to 48%. The most appropriate immediate action is:

Accepted Answer

Increase pump flow and check cannula position

Answer

A significant NIRS drop suggests inadequate cerebral perfusion; increasing pump flow and verifying cannula positioning are the immediate corrective steps.

Question 4

What is the typical safe duration of deep hypothermic circulatory arrest (DHCA) at 18°C before significant neurological risk increases in neonates?

Accepted Answer

30–40 minutes

Answer

At 18°C, approximately 30–40 minutes of DHCA is considered the threshold beyond which neurological injury risk increases substantially.

Question 5

In neonatal perfusion, the estimated blood volume (EBV) for a neonate is approximately:

Accepted Answer

80–85 mL/kg

Answer

Neonates have an EBV of approximately 80–85 mL/kg, which is higher than older children and adults, making hemodilution calculations critically important.

(CCP) Certified Clinical Perfusionist Practice Test

(CCP) Certified Clinical Perfusionist Practice Test

CCP Neonatal & Pediatric Perfusion 3