Book contents
- Cardiopulmonary Bypass
- Cardiopulmonary Bypass
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Human Factors and Teamwork in Cardiac Surgery
- Chapter 2 Equipment for Cardiopulmonary Bypass
- Chapter 3 Monitoring during Cardiopulmonary Bypass
- Chapter 4 Cardiopulmonary Bypass Circuit Setup and Safety Checks
- Chapter 5 Priming Solutions for Cardiopulmonary Bypass Circuits
- Chapter 6 Anticoagulation for Cardiopulmonary Bypass
- Chapter 7 Conduct of Cardiopulmonary Bypass
- Chapter 8 Minimal Invasive Extracorporeal Circulation
- Chapter 9 Considerations for Operations Involving Deep Hypothermic Circulatory Arrest
- Chapter 10 Metabolic Management during Cardiopulmonary Bypass
- Chapter 11 Myocardial Preservation during Cardiopulmonary Bypass
- Chapter 12 Weaning from Cardiopulmonary Bypass
- Chapter 13 Intraoperative Mechanical Circulatory Support and Other Uses of Cardiopulmonary Bypass
- Chapter 14 Mechanical Circulatory Support
- Chapter 15 Cardiopulmonary Bypass for Pediatric Cardiac Surgery
- Chapter 16 Coagulopathy and Hematological Disorders Associated with Cardiopulmonary Bypass
- Chapter 17 Inflammation and Organ Damage during Cardiopulmonary Bypass
- Chapter 18 Neuromonitoring and Cerebral Morbidity Associated with Cardiopulmonary Bypass
- Chapter 19 Renal Morbidity Associated with Cardiopulmonary Bypass
- Chapter 20 Common and Uncommon Disasters during Cardiopulmonary Bypass
- Index
- References
Chapter 10 - Metabolic Management during Cardiopulmonary Bypass
Published online by Cambridge University Press: 24 October 2022
Book contents
- Cardiopulmonary Bypass
- Cardiopulmonary Bypass
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Human Factors and Teamwork in Cardiac Surgery
- Chapter 2 Equipment for Cardiopulmonary Bypass
- Chapter 3 Monitoring during Cardiopulmonary Bypass
- Chapter 4 Cardiopulmonary Bypass Circuit Setup and Safety Checks
- Chapter 5 Priming Solutions for Cardiopulmonary Bypass Circuits
- Chapter 6 Anticoagulation for Cardiopulmonary Bypass
- Chapter 7 Conduct of Cardiopulmonary Bypass
- Chapter 8 Minimal Invasive Extracorporeal Circulation
- Chapter 9 Considerations for Operations Involving Deep Hypothermic Circulatory Arrest
- Chapter 10 Metabolic Management during Cardiopulmonary Bypass
- Chapter 11 Myocardial Preservation during Cardiopulmonary Bypass
- Chapter 12 Weaning from Cardiopulmonary Bypass
- Chapter 13 Intraoperative Mechanical Circulatory Support and Other Uses of Cardiopulmonary Bypass
- Chapter 14 Mechanical Circulatory Support
- Chapter 15 Cardiopulmonary Bypass for Pediatric Cardiac Surgery
- Chapter 16 Coagulopathy and Hematological Disorders Associated with Cardiopulmonary Bypass
- Chapter 17 Inflammation and Organ Damage during Cardiopulmonary Bypass
- Chapter 18 Neuromonitoring and Cerebral Morbidity Associated with Cardiopulmonary Bypass
- Chapter 19 Renal Morbidity Associated with Cardiopulmonary Bypass
- Chapter 20 Common and Uncommon Disasters during Cardiopulmonary Bypass
- Index
- References
Summary
The metabolic management of patients on cardiopulmonary bypass (CPB) is a complex process, involving several key biochemical and physiological parameters essential to maintaining homeostasis and reducing morbidity and mortality associated with CPB and cardiac surgery.There is movement toward goal directed perfusion (GDP), using indexed parameters such as carbon dioxide production, oxygen delivery and oxygen consumption to individualize perfusion strategies. This chapter provides an overview of the fundamental principles surrounding the metabolic management of the patient on CPB.
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- Cardiopulmonary Bypass , pp. 92 - 101Publisher: Cambridge University PressPrint publication year: 2022
References
Suggested Further Reading
Murphy, GS. Hessel, EA 2nd, Groom, RC. Optimal perfusion during CPB: an evidence-based approach. Anesth Analg 2009; 108:1394.Google Scholar
Baker, RA, Nikolic, A, Onorati, F et al. 2019 EACTS/EACTA/EBCP guidelines on CPB in adult cardiac surgery: a tool to better clinical practice. Eur J Cardiothorac Surg 2020; 57: 207– 209.Google Scholar
Reves, JG. Toward understanding cerebral blood flow during CPB: implications for the central nervous system. Anesthesiology 2019; 130: 609–613.CrossRefGoogle ScholarPubMed
American Society of ExtraCorporeal Technology Standards and Guidelines For Perfusion Practice. 2017. Available from www.amsect.org/d/do/1370Google Scholar
Svenmarker, S, Hannuksela, M, Haney, M. A retrospective analysis of the mixed venous oxygen saturation as the target for systemic blood flow control during CPB. Perfusion 2018; 33: 453–462.Google Scholar
Engelman, R. Baker, RA, Likosky, DS et al. The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of ExtraCorporeal Technology: Clinical practice guidelines for CPB temperature management during CPB. J Cardiothorac Vasc Anesth 2015; 29: 1104–1111CrossRefGoogle Scholar
Govender, P, Tosh, W, Burt, C et al. Evaluation of increase in intraoperative lactate level as a predictor of outcome in adults after cardiac surgery. J Cardiothorac Vasc Anesth. 2020 Apr;34(4): 877–884.Google Scholar
Ranucci, M, Carboni, G, Cotza, M et al. Carbon dioxide production during CPB: pathophysiology, measure and clinical relevance. Perfusion 2017; 32: 4–12.Google Scholar
Society of Thoracic Surgeons Blood Conservation Guideline Task Force. Ferraris, VA, Brown, JR, Despotis, GJ et al. Update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 2011; 91: 944–982.CrossRefGoogle Scholar
Kunst, G, Milojevic, M, Boer, C et al. 2019 EACTS/EACTA/EBCP guidelines on CPB in adult cardiac surgery. BJA 2019; 123: 713–757.CrossRefGoogle Scholar