CSCP Clinical Perfusion key terms

A technique in which a machine temporarily takes over the heart's and lungs' functions, oxygenating blood and circulating it through the body while the heart is stopped or bypassed during surgery.

A specially trained allied health professional who operates the heart-lung machine and manages circulatory support, monitoring blood flow, pressure, gases, and coagulation throughout cardiopulmonary bypass and related procedures.

A device in the bypass circuit that adds oxygen to blood and removes carbon dioxide, replacing the gas-exchange function of the lungs during cardiopulmonary bypass.

A non-occlusive or adjustable-occlusion pump that moves blood by compressing tubing between rotating rollers, commonly used for arterial flow and cardioplegia delivery in bypass circuits.

A rotating impeller device that generates blood flow by creating a pressure gradient, offering lower hemolysis and afterload-dependent flow compared with roller pumps.

A cold or warm chemical solution delivered to the heart to induce rapid diastolic arrest and protect the myocardium from ischemic injury during aortic cross-clamping.

A clamp placed across the ascending aorta to isolate the heart from the systemic circulation, allowing cardioplegia delivery and a bloodless surgical field during cardiac arrest.

The set of strategies, including hypothermia, cardioplegic arrest, and substrate supplementation, used to preserve heart muscle function and limit ischemic damage during aortic cross-clamping.

Administration of cardioplegia solution into the coronary arteries through the aortic root or directly into ostia, perfusing the myocardium in the normal direction of blood flow.

Administration of cardioplegia through the coronary sinus so solution flows backward through the venous system, useful when aortic regurgitation or coronary obstruction limits antegrade perfusion.

An anticoagulant that potentiates antithrombin, preventing clot formation in the bypass circuit; its effect is monitored by activated clotting time and reversed with protamine after bypass.

A positively charged protein that binds and neutralizes heparin, used to reverse anticoagulation after cardiopulmonary bypass; it can cause adverse reactions including hypotension and pulmonary hypertension.

A point-of-care whole-blood test measuring the time to clot formation, used to confirm adequate heparin anticoagulation and guide dosing and reversal during bypass procedures.

An inadequate prolongation of clotting time despite standard heparin dosing, often related to antithrombin deficiency, requiring higher doses or antithrombin replacement before initiating bypass.

Recurrence of anticoagulation after protamine reversal, caused by redistribution of heparin from tissue stores, which can increase postoperative bleeding risk.

Reduction of blood hematocrit caused by priming fluid and cardioplegia mixing with circulating blood, lowering viscosity but reducing oxygen-carrying capacity and coagulation factor concentration.

The fluid used to fill and de-air the bypass circuit before initiating support, typically crystalloid or a blood-crystalloid mixture chosen based on patient size and hematocrit goals.

A technique in which the patient's own blood displaces crystalloid prime from the circuit before bypass, reducing hemodilution and transfusion requirements.

The rate at which gas passes through the oxygenator's gas phase, controlling carbon dioxide removal; higher flows reduce carbon dioxide, and lower flows retain it.

A blood gas strategy maintaining pH and carbon dioxide at values measured at 37 degrees Celsius without temperature correction, preserving autoregulation during hypothermia.

A blood gas strategy that temperature-corrects pH and carbon dioxide values, often requiring added carbon dioxide during hypothermia to maintain the desired corrected values.

Deep cooling of the patient to reduce metabolic demand, allowing temporary cessation of circulation to permit surgery on the aortic arch or great vessels.

Strategies such as hypothermia, selective antegrade or retrograde cerebral perfusion, and pH management used to preserve brain function during low-flow or no-flow states.

A catheter placed in the left ventricle or aortic root to decompress the heart, removing blood that returns from the lungs and improving surgical exposure during aortic cross-clamping.

A system that aspirates shed blood from the surgical field into the bypass circuit reservoir for reinfusion, which can activate blood components and cause hemolysis if used excessively.

Destruction of red blood cells with release of hemoglobin, which can occur from shear stress in pumps, suction, and oxygenators and may impair renal function and oxygen delivery.

Tissue damage that occurs when blood flow is restored after a period of ischemia, driven by oxidative stress, calcium overload, and inflammatory responses that can impair organ function.

A whole-body inflammatory reaction triggered by blood contact with artificial surfaces, ischemia, and surgical trauma during bypass, causing capillary leak, fever, and organ dysfunction.

A technique using a semipermeable membrane to remove plasma water and low-molecular-weight solutes from the circuit, concentrating blood and reducing edema after bypass.

The osmotic pressure exerted by plasma proteins, chiefly albumin, that draws fluid into the vascular space; it influences fluid balance and edema formation during and after bypass.

The oxygen saturation of blood returning to the oxygenator from the body, reflecting the balance between oxygen delivery and consumption and helping assess perfusion adequacy.

The total amount of oxygen transported to tissues per minute, calculated as cardiac output multiplied by arterial oxygen content, a key determinant of adequate perfusion.

Cardiac output indexed to body surface area, expressing blood flow per square meter per minute; it is used to set and assess target bypass flow rates.

The average pressure in the arterial system over a cardiac cycle, used to guide vasopressor or vasodilator therapy and assess organ perfusion during bypass.

Ultrasound imaging of the heart and great vessels through a probe in the esophagus, used to assess function, valve pathology, air, and cannula position during cardiac procedures.

The formal documentation maintained by the perfusionist of flows, pressures, gases, medications, and interventions during a procedure, serving as a legal and clinical record.

Collection, processing, and reinfusion of the patient's own shed blood, reducing exposure to donor blood and its associated risks during and after surgery.

The degree to which a roller pump compresses tubing, affecting forward flow and the risk of hemolysis or tubing rupture; it is set and verified before initiating bypass.