Details

Perfusion for Congenital Heart Surgery

Notes on Cardiopulmonary Bypass for a Complex Patient Population
1. Aufl.

von: Gregory S. Matte
156,99 €
Verlag:	Wiley-Blackwell
Format:	PDF
Veröffentl.:	26.02.2015
ISBN/EAN:	9781118900857
Sprache:	englisch
Anzahl Seiten:	208

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Beschreibungen

Titelbeschreibung

A complete guide to the tools and techniques for modeling, simulating, and optimizing SSFE processes and phenomena In Modeling, Simulation, and Optimization of Supercritical and Subcritical Fluid Extraction Processes, a team of expert chemical engineers delivers a comprehensive guide to the tools and techniques used to model supercritical and subcritical fluid extraction (SSFE) processes and phenomena. The book offers details on SSFE experiment management, as well as modeling and optimization of SSFE. The authors begin with a discussion of the fundamentals of SSFE and the necessary experimental techniques to validate the models. They also discuss process simulators, conventional optimization techniques, and state-of-the-art genetic algorithm methods. Several practical examples and case studies on SSFE modeling and optimization techniques are provided. Additionally, detailed thermodynamic modeling with and without co-solvent and non-equilibrium system modeling are covered. Readers will also find: <ul><li>A detailed overview of the field of supercritical and subcritical fluid extraction and their importance to the food, cosmetics, and pharmaceutical industries</li> <li>Explorations of the concepts and methodologies for modeling, simulation, and optimization of SSFE, including conservation laws related to SSFE traditional first principle modeling</li> <li>Practical discussions of the characteristics and physical properties of palm oil as a solute and descriptions of some existing palm oil industrial processes</li> <li>An examination of first principle methodology as applied to the modeling of the properties of palm oil components and mixtures</li></ul> Perfect for researchers, scientists, technologists, and engineers working in food science and the pharmaceutical, cosmetic, and agricultural industries, Modeling, Simulation, and Optimization of Supercritical and Subcritical Fluid Extraction Processes is also a must-read for those working with process design, development, quality control, and improvement in the chemical industries.

Inhaltsverzeichnis

Foreword, x Preface, xi Acknowledgments, xii 1 Equipment for bypass, 1 Oxygenators, 1 Arterial line filters, 12 Tubing packs, 13 Cardioplegia systems, 16 The heart–lung machine, 17 The heater-cooler system, 19 Cannulae, 20 2 Priming the bypass circuit, 27 Prime constituents, 27 Steps for priming, 28 3 The bypass plan, 33 Communication agreement for case, 33 Anticoagulation management, 35 Blood gas management, 40 Carbon dioxide management, 40 Oxygenation strategy, 42 Hematocrit management, 45 Blood pressure management, 47 Temperature management, 49 Flow rates, regional perfusion, and hypothermic circulatory arrest, 52 Methods of ultrafiltration, 55 Before bypass, 55 On bypass, 55 After bypass, 56 SMUF specifications, 59 Standard and augmented venous return, 60 Standard venous return with gravity siphon drainage, 60 Augmented venous return, 60 The prebypass checklist, 63 The surgical safety checklist for congenital heart surgery, 65 4 Typical phases of cardiopulmonary bypass, 72 Commencement of bypass, 72 Standard support phase of bypass, 74 Termination of bypass, 76 Post bypass, 78 5 Additional notes based on bypass tasks, 79 Prebypass, 79 Heart–lung machine (HLM), 79 Reoperations, 79 Cannulation, 79 Transfusion during cannulation, 80 On bypass, 80 Verification of adequate drainage when caval tapes are used, 80 Blood gas management, 80 Cardioplegia delivery, 81 Planned circulatory arrest, 81 Induced ventricular fibrillation, 82 Administration of blood products, 82 Atrial line placement, 82 LV vent placement, 83 Bed rotation during bypass, 83 6 Bypass considerations based on diagnosis, 85 Anomalous coronary arteries, 86 Aortic regurgitation/insufficiency, 89 Aortic stenosis, 91 Aortopulmonary collaterals, 93 Aortopulmonary window, 95 Atrial septal defect, 96 Cardiomyopathy requiring orthotopic heart transplantation, 99 Coarctation of the aorta, 100 Common atrioventricular canal defect, 102 Cor triatriatum, 104 Corrected transposition of the great arteries (L-TGA, Levo-TGA, or C-TGA) or congenitally corrected TGA, 105 Critical aortic stenosis, 107 Double chambered right ventricle, 109 Double inlet left ventricle, 110 Double outlet left ventricle, 111 Double outlet right ventricle, 112 Ebstein’s anomaly, 113 Hypoplastic left heart syndrome, 114 Stage 1 (Norwood) procedure, 115 Hybrid stage 1 palliation, 117 Stage 2 or bidirectional Glenn shunt, 117 Fontan procedure (total cavopulmonary anastomosis), 119 Interrupted aortic arch, 121 Left superior vena cava, 123 Lung transplantation, 124 Mitral regurgitation/insufficiency, 125 Mitral stenosis, 126 Patent ductus arteriosus, 127 Pulmonary artery abnormalities, 128 Pulmonary atresia, 129 Pulmonary atresia with an intact ventricular septum, 129 Pulmonary atresia with ventricular septal defect, 130 Pulmonary regurgitation/insufficiency, 132 Pulmonary stenosis, 133 Pulmonary vein stenosis or pulmonary venous obstruction, 134 Tetralogy of Fallot, 136 Total anomalous pulmonary venous return and partial anomalous pulmonary venous return, 138 d-Transposition of the great arteries, 140 Tricuspid atresia, 142 Tricuspid regurgitation/insufficiency, 143 Truncus arteriosus, 144 Ventricular septal defect, 146 7 Notes on select issues during bypass, 148 Blood pressure higher than expected, 148 Blood pressure lower than expected, 149 Bypass circuit pressure higher than expected, 151 Bypass circuit pressure lower than expected, 152 Central venous pressure elevated, 153 Heat exchange issue (slow cooling or warming), 154 NIRS values lower than expected, 155 PaCO2 higher than expected, 157 PaCO2 lower than expected, 159 PaO2 lower than expected, 160 Reservoir volume acutely low, 161 8 Notes on select emergency procedures during bypass, 163 Arterial pump failure (roller head), 164 Failure to oxygenate, 165 Massive air embolization, 166 Acute aortic dissection at the initiation of bypass, 168 Venous air lock, 169 Inadvertent arterial decannulation, 170 Inadvertent venous decannulation, 171 9 Brief overview of named procedures and terms, 172 Alfieri stitch, 172 Batista procedure, 172 Bentall procedure, 172 Bidirectional Glenn shunt, 172 Blalock–Hanlon procedure, 172 Blalock–Taussig shunt (BTS), 173 Brock procedure, 173 Central shunt, 173 Cone procedure, 173 Cox maze procedure, 173 Damus–Kaye–Stansel anastomosis, 173 Double switch procedure, 173 Fontan procedure, 174 Gott shunt, 174 Hemi–Fontan procedure, 174 Holmes heart, 174 Jatene operation, 174 Kawasaki disease, 174 Kawashima procedure, 175 (Diverticulum of) Kommerell, 175 Konno procedure, 175 LeCompte maneuver, 175 LeCompte procedure, 175 Manougian procedure, 175 Marfan’s syndrome, 175 Maze procedure, 175 Mustard procedure, 176 Nicks procedure, 176 Nikaidoh procedure, 176 Noonan syndrome, 176 Norwood operation, 176 Pannus, 176 Pentalogy of Cantrell, 176 Potts shunt, 177 Rashkind procedure, 177 Rastelli operation, 177 Ross procedure, 177 Sano shunt, 177 Scimitar syndrome, 177 Senning operation, 177 Shone’s complex, 178 Takeuchi procedure, 178 Taussig–Bing anomaly, 178 Trusler repair, 178 Van Praagh classification, 178 Warden procedure, 178 Waterston shunt, 178 Williams syndrome, 178 Yasui procedure, 179 10 Abbreviations for congenital heart surgery, 180 11 Recommended reference books, 186 12 Comprehensive experience-based equipment selection chart select medications administered during bypass, 187 Index, 190

Autorenportrait

GREGORY S. MATTE Perfusion Clinical Coordinator (Co-Chief) Boston Children’s Hospital, Boston, MA, USA

Back cover copy

Perfusion for Congenital Heart Surgery The art and science of providing perfusion for patients undergoing surgical correction of congenital heart lesions has advanced rapidly in the last decade. The complex equipment, the unique acid–base management strategies, the specialized perfusion and ultrafiltration techniques, the wide variation in patient’s age, size, and vulnerability to physiologic trespass, and the wide variety of surgical procedures performed set perfusion for congenital heart surgery apart from that provided for correction of acquired heart disease in adults. Consequently, provision of cardiopulmonary support for repair of congenital heart lesions has become a distinct specialty. Perfusion for Congenital Heart Surgery provides an invaluable road map for the pediatric perfusionist and non-perfusionist caring for patients with congenital heart disease (CHD) in order to confidently devise a plan for a pump run. The easily referenced information and reminders, not currently readily available in any other publication, can be used to influence a bypass plan and form an essential resource for perfusionists, anesthesiologists, intensivists, and other clinicians caring for patients with CHD. This practical, spiral-bound, go-to reference is designed to answer the most frequently posed questions about bypass for CHD, the surgical treatment of which is often complicated, with some conditions seen only rarely in practice. Perfusion for Congenital Heart Surgery is written and designed for regular use and has the following features: <ul><li>Focuses on the latest devices and techniques and provides clear, matter-of-fact guidance on their roles and importance to CHD procedures</li> <li>Written by a seasoned perfusionist who is co-chief and educator at one of the world’s leading children’s hospitals</li> <li>The spiral binding allows the book to be laid flat for easy referral</li> <li>A “Notes” section, following the discussion of each CHD lesion, enables readers to add institution and/or surgeon-specific information for later reference</li></ul>