What is Priming of the Heart Lung Machine??? Basics Explained (part 7) скачать в хорошем качестве

What is Priming of the Heart Lung Machine??? Basics Explained (part 7)

CPB has become dependable, reliable, safe and efficient with a reliability that often exceeds 99.90% thanks to improvements in the conduct of CPB and in the materials used in CPB. In assembling the bypass circuit, the perfusionist must consider the patient's condition, the demographics and pathophysiology of the organ systems, the planned conduct of the operation by the surgeon, and the planned anesthetic management. An ideal priming solution should have the same tonicity, electrolyte composition and pH as that of plasma. Priming solutions were used to fill the cardiopulmonary bypass circuit. This system introduced hemodilution by replacing the blood, with maintenance of the oxygenation during perfusion. Hemodilution leads to decrease in the blood viscosity leading to increased capillary perfusion and fall in SVR, requires lower flows without much need for blood or blood products and hence a lowered load on blood banks and in Jehovah's witnesses. There is a diminished chance of viral transmission and increased urine formation. However, the required hematocrit to be maintained on CPB is about 25 in adults and 30 in kids and again depends on the clinical status of the patient. With increasing hypothermia, lower hematocrit is maintained In adults, priming volumes are commonly in the range of 1400–1800 ml, typically representing 30–35% of the patient’s blood volume. In children, especially infants and neonates, even the minimum priming volume is often far greater than their blood volume, making the use of non-blood-containing primes impossible. Balanced crystalloids are fluids that have a neutral pH as Plasma-Lyte solution (pH 7.4), or slightly low pH (slightly acidotic) as Ringer's (pH 6.6), which are isotonic and consist of electrolyte ions approximately similar to that of human plasma. The usage of colloid fluids in priming solution for cardiopulmonary bypass is beneficial in maintaining of plasma volume during the entire period of operation. Tetra starch (Voluven) 130/0.4 (third generation starch), appears to offer a combination of safety and efficacy. The synthetic colloids appear to be the best suited for the treatment of hypovolemia, and the Voluven seems to offer the best among the currently available albumin and the synthetic colloids by comparison with the cost , safety profile, and efficacy Background music promoted by YouTube audio Library: Toe_Jam: Diamond Ortiz:    • 🎵 Toe Jam - Diamond Ortiz 🎧 No Copyright M...   My Credentials: Facebook :   / the-heart-surgery-factory-102326067972600   Youtube :    / @theheartsurgeon   Gmail: [email protected] Twitter: @theheartsurgeon Instagram:   / sureshbkale6571   #theheartlungmachine, #primingoftheheartlungmachine, #perfusion