Essence of Cardiopulmonary Bypass Circuit and Intra-Aortic Balloon Pump

2021 In: Cheng D.C., Martin J., David T. (eds) Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery. Springer, Cham.

The modern day CPB circuit consists of a series of tubing, pumps, oxygenator, heat exchanger, and numerous safety and electrical components that allow for complete circulatory support, regulation of gas exchange and temperature control. This chapter outlines the fundamentals of cardiopulmonary bypass, associated physiological derangements and utilisation of intra-aortic balloon pumps in cardiac surgical patients.

Main Messages

  1. 1.The CPB circuit is a network of tubing with integrated oxygenators, pumps, filters, heat exchangers and monitoring components, which generates non-pulsatile flow. 
  2. 2.Systemic heparinization is initiated via central venous line at a dose of 350–400 IU/kg aiming to achieve an Activated Clotting Time (ACT) exceeding 480 s. 
  3. 3.CPB circuit increases complications in hematological, cardiovascular, renal, neurological, and pulmonary systems. 
  4. 4.IABP is a mechanical circulatory support device for the management of low cardiac output syndromes, via counterpulsation that results in improvement of the myocardial oxygen supply-demand ratio and coronary perfusion in diastole.