Separation from Cardiopulmonary Bypass: Hemodynamic Considerations

Abstract

The successful transition from full circulatory support to the normal circulatory physiology requires careful attention to a number of parameters that are often perturbed while on cardiopulmonary bypass (CPB). Many of these parameters, such as temperature, extracellular glucose and potassium concentrations, hematocrit, and acid-base status, are relatively easy to restore. However, the re-establishment of many aspects of normal cardiovascular function, such as peripheral vascular resistance, blood pressure, and cardiac function, are not as straightforward, due in part to the unusual physiologic conditions imposed. The purpose of this chapter is to elaborate the cardiovascular physiology relevant to the transition from full circulatory assist, and to describe a model that will allow for a better understanding of the unique consequences that occur.