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Questions and Answers
Who is credited with developing the heart-lung machine?
In what year did Drummond et al. discuss the technological evolution of membrane oxygenators?
What was the key principle underlying the design of early blood oxygenators?
Which publication emphasized the physiologic responses in humans during total body perfusion for open cardiotomy?
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What type of pump is specifically mentioned in the text in relation to blood circulation?
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In which year did Brown, Smith, and Emmons discuss the design and development of a blood heat exchanger for open heart surgery?
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What is the primary function of cardiopulmonary bypass (CPB)?
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What is the purpose of the artificial membrane-type lung ('oxygenator') in the heart-lung machine?
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In cardiopulmonary bypass, where is blood typically drained from using cannulas?
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Why is a heat exchanger included as part of the oxygenator in the cardiopulmonary bypass circuit?
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When might peripheral cannulation be used in cardiac surgery?
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What is the purpose of a roller or centrifugal pump in the heart-lung machine during cardiopulmonary bypass?
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What is the primary function of the venous reservoir in a heart-lung machine?
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In what situation would left heart bypass or proximal aorta bypass be used with extracorporeal membrane oxygenation?
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What is the purpose of an adjustable clamp or remote venous line occluder in the heart-lung machine?
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Where is the venous reservoir typically positioned in relation to the membrane oxygenator in a heart-lung machine?
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What does distal infusion into the distal aorta or femoral artery refer to in the context of a heart-lung machine?
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What is the purpose of a tubing clamp on the systemic arterial inflow line when the patient is not on cardiopulmonary bypass?
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Study Notes
Cardiopulmonary Bypass (CPB)
- The primary function of CPB is to divert blood away from the heart and lungs and return it to the systemic arterial system, allowing cardiac surgery.
- CPB replaces the function of both the lungs (gas exchange) and the heart (circulation of blood).
Blood Pumps
- Blood pumps are used in CPB to pump blood through the artificial membrane-type lung (oxygenator) and back into the systemic vasculature.
- Two types of pumps used are roller pumps and centrifugal pumps.
Extracorporeal Circuit (ECC)
- The ECC is a simplified circuit that includes the heart-lung machine, which contains the oxygenator, pump, and heat exchanger.
- The ECC allows for the exchange of oxygen and carbon dioxide, and also provides circulation of blood.
Oxygenators
- The first membrane oxygenator was developed in 1956 by Clowens et al.
- Membrane oxygenators use diffusion of gases through plastic membranes to exchange oxygen and carbon dioxide.
- The development of membrane oxygenators has evolved over the years, with improvements in design and materials.
Heat Exchangers
- Heat exchangers are included in the oxygenator to offset cooling during extracorporeal passage of blood.
- They are used to cool and then rewarm the patient as needed.
Cannulation
- Cannulation can be performed centrally (SVC and IVC or IVC and RA) or peripherally (femoral or other veins and arteries).
- Peripheral cannulation is occasionally used electively for cardiac surgery when central cannulation is not possible.
Historical Development
- The first artificial lung oxygenator was developed by Dewall et al. in 1956.
- The development of extracorporeal oxygenators has evolved over the years, with contributions from various researchers and scientists.
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Description
Explore the general survey of the circuit in a cardiopulmonary bypass (CPB) system, which diverts blood away from the heart and lungs during cardiac surgery. Learn about the functions of CPB in replacing lung and heart functions, and the techniques involved in blood drainage and circulation.
