RT Book, Section
A1 Hodgson, John A.
A2 Freeman, Brian S.
A2 Berger, Jeffrey S.
SR Print(0)
ID 1135739998
T1 Cardiopulmonary Bypass: Anesthetic Considerations
T2 Anesthesiology Core Review: Part Two Advanced Exam
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9781259641770
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1135739998
RD 2024/04/19
AB Prior  to  placing  a  patient  on  CPB,  the  bypass  machine  must  be  linked  to  the  patient  via  arterial  and  venous  cannulas.  Placement  of  these  cannulas  is  facilitated  by  skilled  management  of  the  patient’s  blood  pressure.  The  arterial  cannula  is  placed  in  the  ascending  aorta  and  in  some  cases,  the  femoral  artery  or  axillary  artery.  The  venous  cannula(s)  are  placed  in  the  right  atrium  and  IVC/SVC.  During  aortic  cannulation  it  is  the  responsibility  of  the  anesthesiologist  to  limit  the  systolic  blood  pressure  to  100  mmHg  to  minimize  the  risk  of  aortic  dissection  during  aortotomy.  This  can  be  achieved  by  either  increasing  the  inhaled  anesthetic  concentration  or  using  vasodilators  such  as  nitroglycerin.  Once  the  aortic  cannula  is  placed,  the  pressure  is  allowed  to  rise  as  the  risk  of  complications  during  venous  cannulation  with  respect  to  systolic  blood  pressure  is  minimal.  In  addition,  at  this  point,  in  many  centers,  the  institution  of  retrograde  autologous  priming  will  commence.