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 2024/10/07 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.