Lesson 1Circuit assembly and priming setup: identifying ports, connectors, venous/arterial lines, cardioplegia line integrationWe go explain systematic circuit assembly and priming setup, including finding ports, connectors, venous and arterial lines, and cardioplegia integration, with ways to avoid wrong connections, air trapping, and flow blocks.
Mapping venous and arterial line pathsIdentifying ports, connectors, and shuntsCardioplegia line routing and safetyStrategies to prevent misconnectionsAir management during initial primingLesson 2Priming solutions selection and calculation: formulas to calculate crystalloid/colloid volumes, blood prime thresholds, strategies to limit hemodilutionWe cover choosing and calculating priming solutions, including crystalloid and colloid volumes, blood prime limits, and methods to reduce hemodilution, with examples and adjustments for different patient types.
Estimating circuit volume and target hematocritCrystalloid versus colloid prime choicesBlood prime indications and thresholdsFormulas to limit hemodilutionWorked calculation examples by weightLesson 3Patient-specific priming considerations: adjusting prime for weight, BSA, hematocrit, renal risk, and COPDWe address tailoring prime and circuit plan to patient factors like weight, body surface area, baseline hematocrit, renal risk, and COPD, balancing viscosity, oxygen delivery, and fluid load to improve outcomes.
Adjusting prime for weight and BSATarget hematocrit by comorbidity profileRenal risk and fluid balance planningStrategies for COPD and lung protectionUltrafiltration and hemoconcentration useLesson 4Pre-bypass functional checks: leak tests, bubble detectors, pressure monitors, emergency stop, pump occlusion, oxygenator integrityWe describe key pre-bypass functional checks of di CPB circuit, including leak testing, bubble detector function, pressure monitoring, emergency stop, pump occlusion, and oxygenator integrity, with steps to fix failures.
Static and dynamic leak testingBubble detector placement and testingPressure transducer zeroing and alarmsPump occlusion and emergency stop testsOxygenator integrity and gas path checksLesson 5Documentation and team communication checklist before cannulationWe outline structured documentation and communication steps before cannulation, including checklists, role confirmation, timeout elements, expected events, and backup plans to ensure shared understanding and patient safety.
Pre-bypass checklist completionConfirming roles and responsibilitiesVerbalizing cannulation strategyDiscussing anticipated complicationsDocumenting baseline status and consentsLesson 6Infection control and sterile field coordination at cannulation siteWe focus on infection prevention and sterile workflow at di cannulation site, including sterile field setup, equipment positioning, traffic control, and coordination between perfusionist, surgeon, and nursing staff to lower contamination risk.
Sterile field layout and boundariesPerfusionist interaction with sterile teamHandling of cannulas and tubing endsManaging line contamination eventsDocumentation of infection control stepsLesson 7Medication and consumable checks: heparin, protamine, vasopressors, inotropes, blood products, antifibrinolytics, filters and oxygenator spare partsWe cover systematic verification of medications and consumables before bypass, including anticoagulants, vasoactive drugs, blood products, antifibrinolytics, filters, and critical spare parts, with labeling, storage, and cross-check procedures.
Heparin dosing, labeling, and availabilityProtamine preparation and backup plansVasopressors and inotropes readinessBlood products and antifibrinolytics setupFilters, oxygenator, and key spare partsLesson 8Monitoring setup verification: arterial lines, central venous/Mixed venous monitoring, temperature probes, cerebral oximetry, ACT point-of-care deviceWe detail verification of monitoring systems before bypass, including arterial and central venous lines, mixed venous sampling, temperature probes, cerebral oximetry, and ACT devices, ensuring accurate calibration, alarms, and documentation.
Arterial pressure line calibrationCentral and mixed venous monitoring setupTemperature probe placement and checksCerebral oximetry positioning and baselinesACT device quality control and loggingLesson 9CPB machine components: roller pump vs centrifugal, membrane oxygenator types, reservoirs, tubing materialsWe review major CPB machine components, comparing roller and centrifugal pumps, membrane oxygenator designs, reservoirs, and tubing materials, with emphasis on hemodynamic performance, safety features, and clinical selection criteria.
Roller versus centrifugal pump mechanicsMembrane oxygenator structure and functionHard-shell versus soft-shell reservoirsTubing materials and biocompatibilityComponent selection for high-risk patients
