The Genesis of a BLOG
The Genesis of a BLOG If this is your first time visiting- click About This Blog on the top menu …
Monthly Archives: February 2011
Saturday Morning Brunch I
Saturday Morning Brunch (Last Weekend of Feb) Wow! Our first informal Saturday Morning Brunch. (To go directly to “comments” …
The “How & Why …”
This is a forum for discussion, a reservoir for perfusion related information, trends, and updates. The intent of this blog …
Angiomax
Angiomax Perfusion Issues Reconstitute Angiomax in OR- 250 mg in powder with 5 cc NSS= 50 mg per ml. No …
Clotting Factors
Clotting Factors
Conditions Affecting Act
Clinical Conditions Affecting Act: -
Hemodilutional Hct
Hemodilutional Hct
Cardioplegia
Cardioplegia Vinten-Johansen J, Nakanishi K. Postcardioplegia acute cardiac dysfunction and reperfusion injury. Journal of Cardiothoracic and Vascular Anesthesia. …
Myocardial Flow & Oxygen Supply
Myocardial Flow & Oxygen Supply Vessels on the epicardial surface of the heart are considered to be conductance vessels …
Cardiac Conduction System
Normal Conduction System Function 1. To generate rhythmical impulses. 2. To conduct the impulses throughout the myocardium. Normal Conductive Tissue …
Depolarization- Repolarization
Depolarization- Repolarization Resting membrane Potential (RMP) Electrical potential of cell at rest. Above example is cardiac muscle tissue. Action Potential …
Cryoprecipitate
Cryoprecipitate Cryoprecipitate contains 2 or more times the concentration of fibrinogen contained in plasma as well as increased levels of …
Desmopressin
Desmopressin Desmopressin acetate (DDAVP) is a synthetic analog of vasopressin and like ADH, epinephrine, and insulin, releases a variety of …
Protamine
Protamine A polycationic protein derived from salmon milt, possess strong alkalinity because of an amino acid composition consisting of …
Aortic Stenosis
Aortic Stenosis Rheumatic heart disease and calcification deposits due to age (senile calcific aortic stenosis) are the most common pathologic …
Cardiac Blood Flow & O2 Consumption
Cardiac Blood Flow & O2 Consumption
CNS & CPB
CNS & CPB The major postoperative neurological complication associated with open-heart surgery and cardiopulmonary bypass is stroke, which is defined …
Intracardiac Pressures
Intracardiac Pressures
Intracardiac Shunts
Principles of Intracardiac Shunts With the continued presence of a congenital defect of the cardiac septum or great vessels in …
Mitral Insufficiency
Mitral Insufficiency Six anatomical components must mesh synchronously to insure proper function of the mitral valve. Disruption of the kinetic …
Myocardial Ischemia
Myocardial Ischemia Prevention and treatment of perioperative myocardial ischemia is a primary consideration. Two consistent factors associated with the pathogenesis …
Myocardial Oxygen Demand
Myocardial Oxygen Demand The heart extracts more oxygen than other tissues while at rest (50-70%). The heart’s normal compensation …
Right Ventricular Function
Right Ventricular Function Patients with right coronary artery disease may be susceptible to right ventricular ischemia and infarction when …
Serotonin
Serotonin Serotonin functions as a neurotransmitter, is synthesized in the gastrointestinal mucosa, and is stored primarily in platelets and the …
Subendocardial Blood Flow Determinants
Subendocardial Blood Flow Determinants While subendocardial and sub-epicardial layers have the same determinants for blood flow, subendocardial layers are …
Pregnancy & CPB
Perfusion of the Pregnant Patient To provide cardiopulmonary bypass to patients which suffer clinical cardiac disease during their pregnancy. When …
AT3 Deficiency
Antithrombin III (AT III) is a plasma glycoprotein with a molecular weight of 58,000 daltons. AT III deficiency may be …
Cold Agglutinins
I. BACKGROUND: Hypothermic cardiopulmonary bypass with the use of cold blood cardioplegia carries with it the risk of red cell …
HIT
Heparin Induced Thrombocytopenia I. DESCRIPTION: Heparin induced thrombocytopenia (HIT) and heparin induced thrombocytopenia thrombosis syndrome (HITTS) are immune mediated complications …
Fetal-Hemoglobin (HbF)
I. DESCRIPTION: Fetal-hemoglobin (HbF) is an abnormal hemoglobin which is characterized by the presence of 2 alpha and 2 gamma …
Protamine Reaction
I. DESCRIPTION: Following cardiopulmonary bypass with heparin anticoagulation, protamine sulfate is used to neutralize the effects of heparin and reverse …
Malignant Hyperthermia
I. PATHOPHYSIOLOGY: Malignant hyperthermia (MH) is a pharmacogenetic disorder characterized by a fulminant hypermetabolic reaction of skeletal muscle induced by …
Methemoglobin
Methemoglobin (METHB) is a condition by which oxygen molecules cannot bind to hemoglobin thus the patient presents with a distinct …
Jehovah’s Witness
JEHOVAH’S WITNESSES Jehovah’s Witness patients are at increased risk for morbidity and mortality associated with blood loss due to their …
Common Pathway (Coagulation)
The endpoint of activity for both the extrinsic and intrinsic pathways for coagulation is the activation of factor X. Reactions …
Coagulopathies
Coagulopathies The most common cause of intraoperative coagulopathy is thrombocytopenia secondary to hemodilution. Thrombocytopenia is a condition where the circulating …
Clotting Factors & Synonyms
Protamine
Protamine Protamine, a polycationic protein derived from salmon milt, possess strong alkalinity because of an amino acid composition consisting of …
The Extracorporeal Circuit
The Extracorporeal Circuit Diversion of blood from the operative site, via an extracorporeal circuit (ECC) is necessary to proceed with …
Fibrinolysis
Fibrinolysis Fibrinolysis is the dissolution of the clot formation process involving the plasma protein plasminogen. This system of enzymes dissolves …
Heparin
HEPARIN ONSET: Maximal at 1 minute past atrial delivery: Measured at radial artery. Note: 10-20% reduction in svr without affecting …
Hemostasis Assays
Partial Thromboplastin Time (Activated) The activated partial thromboplastin time (aPTT) is test that overlaps the prothrombin time (both evaluate the …
Blood Components
Fibrinogen Fibrinogen is a high molecular weight protein occurring in the plasma in quantities of 100 to 700 mg/dl. In …
Activated Clotting Time (ACT)
Activated Clotting Time (ACT) The ACT is a standardized measurement of the patients procoagulation or anticoagulation level. The unit of …
Coagulopathies & Treatment
Coagulopathies & Treatment The most common cause of intraoperative coagulopathy is thrombocytopenia (decrease in platelet count) secondary to hemodilution. Blood …
Coagulation Cascade
Intrinsic Pathway The coagulation cascade is initiated when blood becomes traumatized by exposure to a foreign surface. An example …
