SPDX (MIDTERMS)

• Perfusion - process in which blood is forces to flow through a network of microscopic vessels.
• Perfusate - any fluid flowing through the heart.
• Perfusionist - any individual or rmt responsible for operating extracorporeal circulation equipment.
• Oxygenator system, venous reservoir - cool or re-warm blood.
• Gas line and FiO2 blender - deliver fresh gas to the oxygenator
• Arterial pump - pumps blood from the operative field and vents the heart.
• Arterial line filet - removes microaggregates, >40um.
• Low-level alarm - when level in the reservoir reaches minimum running volume
• Pressure monitoring - when line pressure exceeds set limits.
• bubble detector - when bubbles are sensed
• o2 sensor - when o2 supply to the oxygenator fails.
• Sa o2 Sv o2 and hb monitor - continuously measures these levels
• in-line blood gas monitoring - continuously monitors venous and arterial gases.
• Tubing - interconnects all the main components of the circuit.
• PVC - most commonly used because of its versatility.
• Silicone - for arterial pump boot, releases micro plastics.
• latex rubber - hemolysis
• Tubing size

  • 3/16 (4.5mm) - cardioplegia section of the blood.
  • 1/4 (6.0mm) - suction tubing.
  • 3/8 ((9.0mm) - arterial pump
  • 1/2 (12.0mm) - venous line
• Bicaval cannulation - alternative method of venous cannulation. Requires for cardiac chambers to be open.
• Roller pump - MOST COMMONLY USED.
• Centrifugal pump - there is a cone, when surgery is complex/long.
• Reservior - acts as a chamber for the venous blood.
• Oxygenator - Provides an Interface of high surface area between blood and on one side and gass on the other.
• Hemofilters - semipermeable membrane that permits the passage of water and electrolytes.
• monitoring - in-line blood gas analysis and venous saturation/hct monitors.
• Heparin given


  • Activated clotting time (ACT) >400 seconds
• Arterial cannula

  • Correctly placed
  • Pulsatile swing on an aneroid pressure gauge connected to a side arm of the arterial line
• Venous reservoir


  • Safe level of prime
  • Additional fluid available to add
  • Level alarm activated
• Oxygen analyzer


  • Monitoring gas supply to oxygenator on
  • Alarm activated
• Sweep rate

  Appropriate for patient (usually 2-3l, FIO2=0.6)
• Venous cannula


  • Relatively free of air
• Shunt lines

  Clamped, apart from arterial filter purge line and drug administration manifold line
• No clamps on the arterial or venous lines placed by surgical team
• Alarm overrides deactivated
• Vasopressors prescribed and available
• SAFETY CONCERNS DURING CPB

  • Low-level alarm on venous reservoir
  • High-pressure alarm on the arterial line
  • Bubble alarm
  • Low mixed venous oxygen saturation
  • Clotting
  • Poor blood gasses despite adequate sweep gas delivery and pump flow
  • Electrical activity of the heart
  • Hyperthermia
• Priming - deairing of CPB circuit is done. mixture of crystalloids and colloids
• UFC - standard ac for CPB
• Temperature management - hypothermia is frequently used during CPB
• Tepid - 33-35

  Mild - 31-32

  Moderate - 25-30

  Deep - 15-20