RT Book, Section
A1 Wasnick, John D.
A1 Hillel, Zak
A1 Kramer, David
A1 Littwin, Sanford
A1 Nicoara, Alina
SR Print(0)
ID 8551745
T1 Chapter 17. Cardiopulmonary Bypass
T2 Cardiac Anesthesia and Transesophageal Echocardiography
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-171798-4
LK accessanesthesiology.mhmedical.com/content.aspx?aid=8551745
RD 2024/04/20
AB 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.