DO2 it UP!
15Calculate DO2i if my flow is 4.3 L/min
(everything to the hundredth)
Height = 5' 8''
Weight = 190 lbs
PaO2 = 100 mmHg
Hgb = 15 g/dl
SaO2 = 98%
DO2i = CI x CaO2 x 1000 = 421.96 mlO2/min/m2
(4300 x .19998 )/BSA = 421.15
Cryoprecipitate
Amicar, and why give it?
Antifibrinolytic - prevent post operative bleeding
Of the following, what would decrease your flow?
A. pulmonary edema
B. Hypovolemia
C. pericardial tamponade
D. Kinked venous line
E. All except A
E. All except A
We need a competent ________ for an LVAD to work.
RV
At this minimal target per the patient BSA, we reduce likelihood of AKI and have good oxygenation (give me units!)
> 270 mlO2/min/m2
Proper temperature gradient between what and what, of no more than than this.
Venous line and arterial line, no greater than 10c
Generally speaking, these types of drugs prevent the breakdown of cAMP
phosphodiesterase inhibitors
The optimal place to take a blood sample to assess patient's oxygenation status on VV ECMO, with out the duel lumen cannula, would be.
Left radial line
A severe and acute MI, can lead to
A. Mitral valve incompetence
B. Peripheral embolism
C. Aortic aneurysm
D. All of the above
E. Both A & B
E. A and B
Higher than normal VO2i, probably because of
Depth of anesthesia or temperature
Lower than normal AT III, in relation to Heparin and HDR
Heparin Resistance
Commonly used in chronic heart failure
A. Cardiac glycosides (digoxin)
B. Diuretics
C. ACE Inhibitors
D. All of the above
D. All of the above
For VA ECMO, the indicator and from where, for adequate systemic oxygenation, and to help determine MVO2.
Mixed Venous Saturation
This device is placed percutaneously and the flow is dependent on the P-level
Impella
O2ER, On bypass I want it around what?
20 - 30%
Cannulation and flow direction for LH Bypass and a descending aortic procedure
LA or Left pulmonary vein to pump to femoral artery
Uptake and elimination is inversely proportional to blood gas solubility coefficient: higher the coefficient the more soluble the agent and slower the onset of action
Volatile Anesthetics
(Isoflurane, Halothane, Desflurane, Sevoflurane)
ACT and what other 2 tests, have been shown to be the best standard for ECMO patients.
In patients with rheumatic heart disease, this is most commonly affected
Mitral Valve
SACP, flow and pressure to maintain adequate DO2
Selective antegrade cerebral perfusion
8 - 12 ml/kg and 50 - 70 mmHg
NRP is what and for who and when?
Normothermic Regional Perfusion (NRP)
Donor heart after death, perfusion to vital organs minus the brain
For treatment of angina, all members of this drug class would cause reflex tachycardia
Nitrates
It is possible to have a pre-membrane PO2 equal to the post membrane PO2. Explain 2 options
if oxygenator failure or shunting around oxygenator membrane,
for VV ECMO- recirculation
An axial pump implanted directly on the apex of the heart and primarily used for pediatrics.
Jarvik 2000