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Chapter 6 - Weaning from Cardiopulmonary Bypass

from Section 1 - Routine Cardiac Surgery

Published online by Cambridge University Press:  12 May 2020

Joseph Arrowsmith
Affiliation:
Royal Papworth Hospital, Cambridge
Andrew Roscoe
Affiliation:
Singapore General Hospital
Jonathan Mackay
Affiliation:
Royal Papworth Hospital, Cambridge
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Summary

Failure to wean a patient from CPB at the first attempt after routine cardiac surgery is a relatively uncommon occurrence. Following prolonged, complex or emergency surgery, however, failure to wean is relatively common. In the majority of cases, weaning difficulty can be attributed to myocardial ischaemia secondary to a prolonged AXC time, inadequate myocardial protection, frank MI or coronary embolism. Less common causes include extremes of prosthetic valve malfunction, anastomotic strictures, extremes of vascular resistance and cardiac compression from retained surgical swabs.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

Arrowsmith, JE. Severe bronchospasm following cardiopulmonary bypass. In: Arrowsmith, JE, Simpson, J (eds). Problems in Anesthesia: Cardiothoracic Surgery. London: Martin Dunitz; 2002, pp. 133–8.CrossRefGoogle Scholar
Intra-aortic Balloon Counterpulsation Therapy: Theory Program. Getinge Education Academy. https://getinge.training/d/course/1010001718/ (accessed December 2018).Google Scholar
Toshner, M, Pepke-Zaba, J. Pulmonary hypertension in the cardiothoracic intensive care unit. In Valchanov, K, Jones, N, Hogue, CW (eds.). Core Topics in Cardiothoracic Critical Care, 2nd edn. Cambridge: Cambridge University Press; 2018, pp. 272–77.Google Scholar

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