Abstract
Since its first clinical use in the 1950s, cardiopulmonary bypass (CPB) has evolved and expanded each year to change the lives of thousands of people who have congenital or acquired cardiac disease. Although CPB now saves lives routinely, its use does result in an abnormal physiologic state. Drs. Kirklin and Barratt-Boyer have remarked, “The patient whose arterial blood flow is temporarily provided by means of a pump oxygenator is in an abnormal state that affects most, if not all, of the body’s physiologic processes.”1
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References
Kirklin JW, Barratt-Boyer BG. Hypothermia, circulatory arrest, and cardiopulmonary bypass. In: Kirklin JW, Barratt-Boyer BG, eds. Cardiac Surgery 2nd ed. New York: Churchill Livingstone; 1993; 75.
Stoney WS, Alford WC Jr, Burrus GR, et al. Air embolism and other accidents using pump oxygenators. Ann Thorac Surg 1980; 29: 336–340.
Wheeldon DR. Can cardiopulmonary bypass be a safe procedure? In: Longmore DB, ed. Towards Safer Cardiac Surgery. Lancaster, London: MTP; 1981: 427–446.
Kurusz M, Conti VR, Arens JF, et al. Perfusion accident survey. Proc Am Acad Cardiovasc Perf 1986; 7: 57–65.
Gaba DM, Maxwell M, Deanda A. Anesthetic mishaps: breaking the chain of accident evolution. Anesthesiology 1987; 66: 670–676.
Keenan RL, Boyan CP. Cardiac arrest due to anesthesia — a study of incidence and causes. JAMA 1985; 253: 2373–2377.
Cooper JB, Newbower RS, Long CD, et al. Preventable anesthesia mishaps: a study of human factors. Anesthesiology 1978; 49: 399–406.
Cooper JB, Newbower RS, Kitz RJ. An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection. Anesthesiology 1984; 60: 34–42.
Utting JE, Gray TC, Shelley FC Human misadventure in anaesthesia. Can Anaesth Soc J 1979; 26: 472–478.
Lunn JN, Hunter AR, Scott DB. Anaesthesia-related surgical mortality. Anaesthesia 1983; 38: 1090–1096.
Kurusz M, Wheeldon DR. Risk containment during cardiopulmonary bypass. Semin Thorac Cardiovasc Surg 1990; 2: 400–409.
Chung F, David TE, Watt J. Excessive requirement for heparin during cardiac surgery. Can Anaesth Soc J 1981; 28: 280–282.
Anderson EF. Heparin resistance prior to cardiopulmonary bypass. Anesthesiology 1986; 64: 504–507.
Esposito RA, Culliford AT, Colvin SB, et al. Heparin resistance during cardiopulmonary bypass — the role of heparin pretreatment. J Thorac Cardiovasc Surg 1983; 85: 346–353.
Bull BS, Korpman RA, Huse WM, et al. Heparin therapy during extracorporeal circulation — I. Problems inherent in existing heparin protocols. J Thorac Cardiovasc Surg 1975; 69: 674–684.
Kurusz M, Shaffer CW, Christman EW, et al. Runaway pump head: new cause of gas embolism during cardiopulmonary bypass. J Thorac Cardiovasc Surg 1979; 77: 792–795.
Taylor PC, Groves LK, Loop FD, et al. Cannulation of the ascending aorta for cardiopulmonary bypass: experience with 9,000 cases. J Thorac Cardiovasc Surg 1976; 71: 255–258.
Ross WT, Lake CL, Wellons HA. Cardiopulmonary bypass complicated by inadvertent carotid cannulation. Anesthesiology 1981; 54: 85–86.
McLeskey CH, Cheney FW. A correctable complication of cardiopulmonary bypass. Anesthesiology 1982; 56: 214–216.
Horrow JC. Protamine: a review of its toxicity. Anesth Analg 1985; 64: 348–361.
Weiler JM, Gellhaus MA, Carter JG, et al. A prospective study of the risk of an immediate adverse reaction to protamine sulfate during cardiopulmonary bypass surgery. J Allergy Clin Immunol 1990; 85: 713–719.
Hill AG, Lefrak EA. Cardiopulmonary bypass safety devices and techniques. Proc Am Acad Cardiovasc Perf 1985; 6: 38–42.
Vivian WA, Stander KH, Smith GR. An air embolism detection device for use with a non-occlusive arterial pumphead. J Extracorp Technol1987; 19: 406–407.
Blanche C, MacKay D, Lee ME. A new overpressure safety valve for use in the venting line during cardiopulmonary bypass. Mt Sinai JMed 1986; 53: 239–240.
Stofer RC, Reed CC. The hidden hazards of perfusion. Proc Am Acad Cardiovasc Perf 1982; 3: 46–48.
Oka Y, Inoue T, Hong Y, et al. Retained intracardiac air–transesophageal echocardiography for definition of incidence and monitoring removal by improved techniques. J Thorac Cardiovasc Surg 1986; 91: 329–338.
Orihashi K, Matsuura Y, Hamanaka Y, et al. Retained intracardiac air in open heart operations examined by transesophageal echocardiography. Ann Thorac Surg 1993; 55: 1467–1471.
Kurusz M, Crane TN, Speer D. Preventive maintenance of heart-lung machines. Proc Am Acad Cardiovasc Perf 1985; 6: 34–37.
Crane TN, Keen WR, Spiller CE, et al. A prebypass checklist-why aren’t you using one? Proc Am Acad Cardiovasc Perf 1986; 7: 98–100.
Mills NL, Ochsner JL. Massive air embolism during cardiopulmonary bypass — causes, prevention, and management. J Thorac Cardiovasc Surg 1980; 80: 708–717.
Bayindir O, Paker T, Akpinar B, et al. Case 6 1991 — A 58year-old man had a massive air embolism during cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1991; 5: 627–634.
Spampinato N, Stassano P, Gagliardi C, et al. Massive air embolism during cardiopulmonary bypass: successful treatment with immediate hypothermia and circulatory support. Ann Thorac Surg 1981; 32: 602–603.
Peirce EC. Specific therapy for arterial air embolism. Ann Thorac Surg 1980; 29: 300–303.
Kumar AS, Jayalakshmi TS, Kale SC, et al. Management of massive air embolism during open heart surgery. Int J Cardiol 1985; 9: 413–416.
Ghosh PK, Kaplan O, Barak J, et al. Massive arterial air embolism during cardiopulmonary bypass. J Cardiovasc Surg 1985; 26: 248–250.
Stark J, Hough J. Air in the aorta: treatment by reversed perfusion. Ann Thorac Surg 1986; 41: 337–338.
Brown JW, Dierdorf SF, Moorthy SS, et al. Venoarterial cerebral perfusion for treatment of massive arterial air embolism. Anesth Analg 1987; 66: 673–674.
Toscano M, Chiavarelli R, Ruvolo G, et al. Management of massive air embolism during open-heart surgery with retrograde perfusion of the cerebral vessels and hyperbaric oxygenation. Thorac Cardiovasc Surg 1983; 31: 183–184.
Hendriks FFA, Bogers AJJC,, de la Riviere AB et al. The effectiveness of venoarterial perfusion in treatment of arterial air embolism during cardiopulmonary bypass. Ann Thorac Surg 1983; 36: 433–436.
Kol S, Ammar R, Weisz G, et al. Hyperbaric oxygenation for arterial air embolism during cardiopulmonary bypass. Ann Thorac Surg 1993; 55: 401–403.
Armon C, Deschamps C, Adkinson C, et al. Hyperbaric treatment of cerebral air embolism sustained during an open-heart surgical procedure. Mayo Clin Proc 1991; 66: 565–571.
Bitterman H, Melamed Y. Delayed hyperbaric treatment of cerebral air embolism. Israel JMed Sci 1993; 29: 22–26.
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Sadel, S.M. (1995). Safety and Management of Perturbations During Cardiopulmonary Bypass. In: Mora, C.T., Guyton, R.A., Finlayson, D.C., Rigatti, R.L. (eds) Cardiopulmonary Bypass. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2484-6_18
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DOI: https://doi.org/10.1007/978-1-4612-2484-6_18
Publisher Name: Springer, New York, NY
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