cardiopulmonary bypass principles and practice pdf

Cardiopulmonary Bypass Principles And Practice Pdf

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Cardiopulmonary Bypass and Mechanical Support: Principles and Practice

If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Please consult the latest official manual style if you have any questions regarding the format accuracy. Perfusion science is a unique discipline unto itself and a full discussion of its many intricacies is far beyond the scope of this introduction to cardiac anesthesia and echocardiography.

Still, much that is unique to cardiac anesthesia care can be in some degree related to the use of cardiopulmonary bypass CPB. At the start it is important for the practitioner new to cardiac anesthesia to establish a close working partnership with their perfusionist colleagues. Perfusionists are certified healthcare professionals who devote their careers to the management of circulatory support.

In most institutions they work under the direct authority of the attending surgeon; however, from time to time they are under the medical direction of the anesthesiologist. At no times must they be considered a substitute for an appropriately qualified anesthesia practitioner in the operating room.

Hence, during the "bypass run" a member of the patient's anesthesia team must be physically present in the operating room. During CPB, the anesthesiologist and the perfusionist work together to bypass the functions of the heart and the lungs so that cardiac surgery may proceed. The pump's flow becomes the patient's cardiac output CO.

The oxygenator of the CPB machine provides gas exchange. Simply put, the hemodynamic principles, which guide normal patient management, are operative when the bypass machine is in use. Blood pressure is still the product of cardiac output and systemic vascular resistance—except that the CPB machine provides the cardiac output.

CPB has been in use in cardiac surgery for more than 50 years. It is likely that over that time successive generations of anesthesia trainees have been initially overwhelmed by the complexity of the bypass machine. Nonetheless, the basic circuit is straightforward enough Figure 17—1. Anticoagulated venous blood is drained from the right atrium or directly from the superior and inferior venae cavae through the venous cannula and associated tubing to the pump reservoir. The deoxygenated venous blood is returned to the patient after passing through a gas exchanger or oxygenator as well as a heat exchanger to control the desired blood and hence patient temperature.

In the oxygenator, carbon dioxide is swept away by the oxygen gas flow across a gas permeable membrane. Oxygenated blood is then returned to the patient through a cannula most often placed in the ascending aorta or occasionally in a femoral artery.

Along the oxygenated blood's course there are a number of filters and alarms to prevent the perfusionist from pumping air or clot into the aorta resulting in a perioperative embolic catastrophe.

Venous blood is drained from the patient, flows through the pump oxygenator, and is returned oxygenated to the arterial system. Other functions of a simple CPB circuit is to deliver cardioplegia solution to the heart as well as suction blood from the surgical field to be oxygenated, filtered, and returned to the patient. Of course, Forgot Password? Otherwise it is hidden from view. Forgot Username? About MyAccess If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

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Download Cardiopulmonary Bypass: Principles and Practice PDF Free

If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Please consult the latest official manual style if you have any questions regarding the format accuracy. Perfusion science is a unique discipline unto itself and a full discussion of its many intricacies is far beyond the scope of this introduction to cardiac anesthesia and echocardiography. Still, much that is unique to cardiac anesthesia care can be in some degree related to the use of cardiopulmonary bypass CPB. At the start it is important for the practitioner new to cardiac anesthesia to establish a close working partnership with their perfusionist colleagues. Perfusionists are certified healthcare professionals who devote their careers to the management of circulatory support.

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. Gravlee and J. Hammon and R. Gravlee , J.

Basics of cardiopulmonary bypass

Cardiopulmonary bypass CPB provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump. Team effort between surgeon, perfusionist and anaesthesiologist is paramount for the successful use of CPB.

Basics of cardiopulmonary bypass

Cardiopulmonary Bypass and Mechanical Support: Principles and Practice

Now in its third edition, Dr. Gravlee's text is established as the standard reference on cardiopulmonary bypass. This comprehensive, multidisciplinary text covers all aspects of cardiopulmonary bypass including sections on equipment, physiology and pathology, hematologic aspects, and clinical applications.

Cardiopulmonary Bypass: Principles and Practice, 3rd Edition. Edited by Glenn P. Gravlee, M. Davis, M.

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Cardiopulmonary Bypass

In the preface to the third edition of Cardiopulmonary Bypass , the editors admit to having had second thoughts before undertaking this revision. In particular, they considered the impact of falling numbers of coronary artery bypass graft procedures resulting from the seemingly inexorable rise in the use of coronary angioplasty. Obviously, they decided that cardiopulmonary bypass was alive and well and they cite a number of growth areas, including the increasing incidence of degenerative valvular heart disease, in support of this view. The subsequent concerns that have arisen regarding drug eluting stents suggest that the rumours regarding the demise of coronary artery bypass surgery have been exaggerated and further justify the Editors' decision to proceed.

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Cardiopulmonary Bypass pp Cite as. Cardiopulmonary bypass CPB is used so routinely in hospitals around the world that most of the participants — surgeons, anesthesiologists, perfusionists, operating room nurses and, above all, patients — forget that this landmark in clinical technology is not even 40 years old. In fact, many of the pioneers are still active in the field. The purpose of this chapter is to recall the inventiveness displayed by a small coterie of gifted investigators to whom we owe the mechanical and physiologic foundations of open-heart surgery, and to reflect on the new demands that continuing clinical advances will undoubtedly make on this technology. Unable to display preview.

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