Cardiopulmonary Bypass 2nd Edition by Sunit 1316424340 9781316424346

Cardiopulmonary Bypass 2nd Edition by Sunit Ghosh – Ebook Instant Download/Delivery ISBN(s): 1316424340, 9781316424346

Product details:

• ISBN 10: 1316424340
• ISBN 13: 9781316424346
• Author: Sunit

Cardiopulmonary Bypass, 2nd edition, offers a complete introduction to this specialist technique for medical and technical personnel involved in extracorporeal cardiopulmonary support. A clinically based overview of the subject is provided and updated chapters incorporate the most current developments in the field. Introductory chapters cover equipment and preparation of the cardiopulmonary bypass machine, safety and monitoring, routine conduct of bypass, and the process of weaning from mechanical to physiological circulation. Specialist chapters on mechanical support, ECMO, special surgical procedures, blood conservation techniques, and particular medical conditions that affect the conduct of cardiopulmonary bypass are also included. This new edition includes self-assessment multiple choice questions at the end of each chapter, allowing readers to test their own understanding of the material. Written and edited by specialists from leading cardiac centres in the UK and USA, this is an invaluable resource for clinical perfusion scientists, cardiac surgeons and cardiothoracic anaesthetists in training.

Table of contents:

1 Procedure for setting up and priming a standard heart–lung bypass system

1.1 The heart–lung machine and accessories

1.1.1 Connection checks:

1.1.2 Each pump head is checked:

1.1.3 That other electrical safety devices are in working order:

1.2 The set-up of disposable heart–lung equipment

1.2.1 The oxygenator:

1.2.2 The circuitry

1.2.3 The cardiotomy reservoir if required:

1.2.4 The cardioplegia system if required:

1.2.5 The centrifugal pump if required:

1.2.6 Arterial line filters if required:

1.2.7 Cell saver if required:

1.2.8 Pre-bypass filters if used:

1.3 In-line blood chemistry/gas analyzer (e.g. CDI 500) set-up and calibration

1.3.1 Set-up of CDI 500 arterial sensor shunt:

1.3.2 Set-up of CDI 500 venous line sensor:

1.4 Priming the system

1.4.1 Standard prime:

1.4.2 Priming cardioplegia if required:

1.4.3 Priming the arterial line filter if required:

1.4.4 Priming centrifugal pump if required:

1.4.5 Calibrating the flow probes

1.5 Setting occlusions

1.5.1 Occlusion of the arterial pump if a roller pump is used:

1.5.2 Occlusion of the suction pumps:

Appendix 2.2 Electronic Safety Devices

2.1 Level sensors

2.2 Bubble detectors

2.3 Pressure alarms

2.4 Temperature alarms

2.5 Gas alarms

2.6 Electrical failure alarm

Chapter 3 Priming solutions for cardiopulmonary bypass circuits

Prime volume and hemodilution

Acceptable hemodilution

Autologous blood priming

Mini-bypass circuits

Priming solutions

Blood

Crystalloids

Dextrose

Balanced crystalloid solutions

Colloids

Albumin

Dextrans

Gelatins

Hydroxyethyl starch (HES)

Additives

Mannitol

Sodium bicarbonate

Experimental oxygen-carrying solutions

Self assessment

Chapter 4 Anticoagulation, coagulopathies, blood transfusion, and conservation in cardiac surgery

The coagulation cascade

Pharmacological strategies for anticoagulation during CPB

Heparin

Structure

Mechanism of anticoagulant action

Dosing

Monitoring

Heparin resistance

Heparin-induced thrombocytopenia (HIT)

Alternatives to unfractionated heparin

Low-molecular-weight heparin

Direct thrombin inhibitors

“Reversal” of anticoagulation

Heparin neutralization

Alternatives to protamine

Platelet factor 4 (PF4)

Methylene blue

Omit neutralization

Heparinase

Monitoring anticoagulation status in the operating room

Point-of-care testing (POC)

Tests of platelet function

Thromboelastography (TEG)

Agonist-induced POC tests of platelet function

Coagulation disorders after CPB

Platelet abnormalities

Systemic inflammatory response syndrome

Heparin rebound

Hypothermia

Fibrinolysis

Other causes

Prevention of bleeding

Antifibrinolytic agents

Heparin and protamine dosing

Management of the bleeding patient

Transfusion and the use of algorithms

Self assessment

Chapter 5 Conduct of cardiopulmonary bypass

Arterial cannulation

Connection to patient

Complications of aortic root cannulation

Peripheral arterial cannulation

Venous cannulation and drainage

Connection to the patient

Peripheral venous cannulation

Cardiotomy suction

Adverse effects of cardiotomy suction

Venting the heart

Venting the left heart

Venting the right heart

Venting methods

General management of CPB

Transitioning the patient onto CPB

Recommended flow rates for CPB

Hemodilution

Mean arterial blood pressure (MAP)

Pulmonary artery (PA) and left atrial (LA) pressure

Central venous pressure (CVP)

Electrocardiogram

Temperature

Urine volume

Transesophageal echocardiography (TEE)

Laboratory investigations

Termination of CPB

Miniature extracorporeal circulation

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