Hemodynamics and Monitoring Flashcards

What is the significance of the pressure gradient across the oxygenator?

Answer: A rising gradient suggests clot formation or fiber damage within the oxygenator

Increasing pressure across the oxygenator suggests obstruction from clot formation, fibrin deposition, or membrane damage, potentially requiring oxygenator replacement.

What is pump flow rate and how is it determined?

Answer: The volume of blood delivered per minute, calculated based on body surface area and desired cardiac index

Pump flow rate is individualized based on the patients body surface area to achieve an appropriate cardiac index, typically 2.2-2.4 L/min/m².

What is the purpose of in-line blood gas monitoring during bypass?

Answer: Continuous real-time measurement of blood gases, pH, and electrolytes for immediate adjustments

In-line monitoring provides continuous, real-time blood gas data allowing the perfusionist to make immediate adjustments to ventilation and perfusion parameters.

What is the significance of urine output during cardiopulmonary bypass?

Answer: It reflects renal perfusion adequacy; low output may indicate insufficient kidney blood flow

Adequate urine output suggests the kidneys are receiving sufficient blood flow. Decreased output may signal inadequate perfusion or renal compromise.

What is a perfusion emergency known as massive air embolism?

Answer: Introduction of a large volume of air into the patients arterial system through the bypass circuit

Massive air embolism is a catastrophic event where air enters the patients arterial system, potentially causing stroke, organ damage, or death.

What electrolyte imbalance is most concerning during bypass?

Answer: Hyperkalemia, which can cause cardiac arrhythmias

Hyperkalemia (high potassium) is particularly dangerous during bypass as it can cause fatal cardiac arrhythmias, especially important to monitor given potassium-containing cardioplegia.