CVP Cardiopulmonary Bypass (CPB) Management 3

Question 1

During CPB, the perfusionist notices the arterial line pressure is rising while pump flow remains constant. What is the most likely explanation?

Accepted Answer

Aortic cannula malposition or partial obstruction

Answer

Rising arterial line pressure at constant flow suggests increased resistance, most commonly due to aortic cannula malposition, kinking, or partial obstruction.

Question 2

Which type of CPB circuit component is most responsible for hemolysis due to mechanical shear stress?

Accepted Answer

Roller pump

Answer

Roller pumps generate the highest mechanical shear stress on red blood cells, making them the primary source of pump-related hemolysis in the CPB circuit.

Question 3

A perfusionist is managing a patient with known heparin-induced thrombocytopenia (HIT). Which anticoagulant is most appropriate for CPB?

Accepted Answer

Bivalirudin

Answer

Bivalirudin is the preferred direct thrombin inhibitor for CPB anticoagulation in patients with confirmed HIT, as heparin is contraindicated.

Question 4

What is the purpose of retrograde autologous priming (RAP) in CPB circuits?

Accepted Answer

To reduce hemodilution by displacing crystalloid prime with patient's blood

Answer

RAP replaces crystalloid prime in the circuit with the patient's own blood before bypass, reducing hemodilution and transfusion requirements.

Question 5

During rewarming on CPB, what is the recommended maximum temperature gradient between the water heater and the patient's blood to prevent gas emboli?

Accepted Answer

14°C

Answer

A maximum gradient of 10–14°C between the heat exchanger water temperature and blood temperature is recommended to prevent gas supersaturation and bubble formation.

(CVP) Cardiovascular Perfusionist Practice Test

(CVP) Cardiovascular Perfusionist Practice Test

CVP Cardiopulmonary Bypass (CPB) Management 3