cardiopulmonary bypass; heart-lung machine; extracorporeal membrane oxygenation (ECMO)
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Indications
- cardiac surgery
- lung transplantation
- vascular surgery involving the aortic root &/or ascending thoracic aorta
- heart failure
Laboratory
- activated clotting time before initiation & at regular intervals - matintain > 480 seconds[2]
Procedure
- surgical procedure bypassing the heart & the lungs using a device that pumps & oxygenates blood (extracorporeal membrane oxygenator)
Complications
- high risk of postoperative stroke mostly due to atrial fibrillation[3]
Management
- anticoagulation with heparin
- bivalirudin is a reasonable option for patients with heparin-induced thrombocytopenia
Notes
- 1/3 of heater-cooler devices used in bypass surgery may be contaminated with Mycobacterium chimaera[1]
More general terms
More specific terms
Additional terms
References
- ↑ 1.0 1.1 Association for Professionals in Infection Control & Epidemiology More than a third of heater-cooler devices used in open heart surgery may be contaminated with deadly bacteria. June 14, 2017 https://apic.org/For-Media/News-Releases/Article?id=cfa1fb1b-e399-46fa-82f4-9b18e71004f3
- ↑ 2.0 2.1 Cardiopulmonary Bypass and Anticoagulation Society of Thoracic Surgeons, Society of Cardiovascular Anesthesiologists, and American Society of ExtraCorporeal Technology. In: Anello J, Feinberg B, Heinegg J et al New Clinical Practice Guidelines, February 2018. Medscape. February 07, 2018 https://reference.medscape.com/viewarticle/892328
Shore-Lesserson L, Baker RA, Ferraris VA, et al. The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines - Anticoagulation During Cardiopulmonary Bypass. Ann Thorac Surg. 2018 Feb;105(2):650-62. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29362176 <Internet> http://www.annalsthoracicsurgery.org/article/S0003-4975(17)31478-9/fulltext - ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 19. American College of Physicians, Philadelphia 2021