SWAN GANZ & SAFETY
This type of tubing must be used for invasive blood pressure monitoring?
What is stiff, incompressible tubing?
The date of the first successful cardiopulmonary bypass procedure using a HLM?
What is May 6, 1953.
A kinetic pump flow is limited by what two factors.
What are preload and afterload?
This type of oxygenator uses a sparger plate to bubble oxygen or carbogen into the venous blood.
What is a bubble oxygenator?
Loading dose of heparin for patient going on CPB.
What is 300-400 units/kg
Traps particles in a thick woven medium.
What is a depth filter?
With regards to invasive BP monitoring, what is catheter "whip"?
What is a small catheter in a larger vessel, allowing tip to move "whip" within the vessel.
The waveform is defined as UNDERDAMPED
Father of Open Heart Surgery
Who is C. Walton Lillehei?
Time to draining your reservoir:
750ml in reservoir, 5 LPM flow.
What is 750ml/5000ml/min X 60sec/min=
9 seconds?
The "True Membrane Oxygenator"
What is a rolled flat plate membrane oxygenator?
This occurs when an arterial blood pressure transducer is located below the phlebostatic axis (RA) of a patient.
What is a falsely elevated blood pressure?
The pre-bypass filter is this type of filter with this size of filtration limit.
What is a screen filter and 0.2 micron size?
Percentage of cardiac output required by the brain.
What is 15-20%?
Michael DeBakey
Who created the roller pump design still used today?
Flow control on this type of pump is fixed.
What is a roller pump?
Uses RPM's to determine flow.
Hollow-fiber membrane Oxy's used during CPB are made of this type of fiber.
What are micro-porous polypropylene fibers?
List 4 examples of PPE.
What are gloves, goggles, gowns, masks, face shields, hats.
The cardiotomy section of an open venous reservoir contains these types of filters.
What is depth (20-40 micron) and de-foaming filters?
The resistance the heart has to pump against in the systemic circulation, excluding the lungs.
What is SVR?
SVR=80x(MAP-CVP)/CO dynes.sec.cm-5
First transplant in US was performed by this surgeon in what year?
Norman Shumway, 1968.
This type of flow mimics phsyiologic body funcion.
What is pulsatile flow?
Hollow fiber membrane oxy's used during ECMO are made of this type of fiber.
What are Polymethylpentane (non-porous) fibers?
Bubble point pressure
What is the pressure point at which air can be forced through a hydrophilic filter mesh?
Typical sites used for bi-caval venous cannulation.
What are the SVC and IVC?
Discussion point: Which gets larger venous cannula?
In a supine patient, this formal location is used as the reference point when leveling an arterial pressure transducer.
What is the phlebostatic axis (4th intercostal space and midpoint of anterior/posterior surfaces of the chest)?
This technique was first done successfully in 1954, but abandoned due to it's possible 200% mortality.
What is the cross-circulation technique?
Servo-regulation is.....
What is a computer controlled system that adjusts flow based on feedback. Can be in response to pressure or level limits. Can be used with centrifugal or or roller pumps.
Describe the mechanism of plasma leakage in a hollow fiber membrane oxygenator
Hydrophobic fibers degrade into hydrophilic fibers which become "wet" and allow plasma to leak across the micro-porous fibers.
The action of heparin.
These cannulation sites can be used as alternative arterial sites during aortic arch or aortic dissection repairs.
What are axillary and femoral arteries?
List 4 of several measurements taken from a Swan-Ganz catheter.
What are CO, CVP (RAP), PAP, PCWP, blood temp, SvO2
This oxygenator became the early standard for ECMO.
What is the Kolobow silicone membrane oxy (Kolobow Lung)?
Approximate volume per 1ft of tubing:
1/4"
3/8"
1/2"
What is 10 ml, 22ml, and 39ml
List 3 factors that can affect oxygenation while on CPB.
What are hematocrit, temperature, venous saturation, blood flow rate, and membrane permeability?
This size of bubble is most efficient at removing C02.
What is a larger bubble? (when compared to smaller bubbles that provide more efficient O2 transfer.)
3 ways to deliver cardioplegia and sites of delivery.
What are antegrade in aortic root, retrograde in the coronary sinus, and hand-helds directly into coronary ostia.
When not on CPB, these 3 factors can affect arterial blood pressure.
Home to the first hospital based perfusion training program and still exists today.
What is the Cleveland Clinic ? (1963)
Designed to decrease blood product usage, post-op bleeding, complement activation and reduce activation of formed elements.
What are biocompatible tubing coatings?
The rate of diffusion is dependent on these 3 factors.
What are distance, concentration gradient, and surface area?
The 2 types of flow patterns that can be seen in an oxygenator/heat exchanger.
What are axial and radial flow patterns?
A combination of these 3 filter types can be found in a hard shell venous reservoir.
What are screen (40microns), depth (20-40 microns), and de-foaming (polyurethane) filters?