CCS Cardiopulmonary Bypass and Perfusion Management Flashcards
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What is the primary purpose of cardiopulmonary bypass (CPB) during cardiac surgery?
Answer: To temporarily take over heart and lung function allowing a bloodless operative field
CPB temporarily assumes the functions of the heart and lungs, providing oxygenated blood to the body while the surgeon operates on a still, decompressed heart.
Cardioplegia solution is used intraoperatively primarily to achieve which goal?
Answer: Arrest and protect the heart during aortic cross-clamping
Cardioplegia causes diastolic cardiac arrest and reduces myocardial oxygen demand, protecting the heart during the ischemic cross-clamp period.
The standard target activated clotting time (ACT) for full anticoagulation during cardiopulmonary bypass is greater than how many seconds?
Answer: 300 seconds
An ACT greater than 300 seconds (often targeted >480 seconds at some centers) is required to prevent clot formation in the CPB circuit.
Which drug is the primary anticoagulant used during cardiopulmonary bypass?
Answer: Heparin
Unfractionated heparin is used for anticoagulation during CPB because it is rapidly reversible with protamine sulfate after bypass.
What is the typical target mean arterial pressure (MAP) maintained during cardiopulmonary bypass?
Answer: 50–80 mmHg
A MAP of 50–80 mmHg is targeted during CPB to ensure adequate cerebral and end-organ perfusion while minimizing hemodilution effects.
Aortic cross-clamping during CPB isolates the coronary circulation and results in which immediate myocardial state?
Answer: Global ischemia
Aortic cross-clamping stops all coronary flow, producing global myocardial ischemia that must be mitigated by cardioplegia and hypothermia.