Heart-lung machine components, oxygenator types, and cardiopulmonary bypass circuit setup tested on the ABCP certification exam.
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- What are the two main pumping mechanisms used in modern CPB pump consoles?
- Roller pumps and centrifugal pumps
- What is the main advantage of a centrifugal pump over a roller pump?
- It is afterload-dependent and stops generating flow against a fully occluded line, reducing the risk of massive air embolism or line rupture
- What is the main advantage of a roller pump over a centrifugal pump?
- It delivers flow that is largely independent of afterload, so output is more predictable at a given rpm setting
- What is pump head occlusion, and why is it adjusted on a roller pump?
- The degree the rollers compress the tubing; it is set to just prevent retrograde flow (near-occlusive) to minimize tubing wear and hemolysis
- What are the two general categories of blood oxygenators used in CPB?
- Membrane oxygenators and bubble oxygenators
- What is the current standard oxygenator design used in nearly all adult CPB circuits?
- The hollow fiber membrane oxygenator
- Why have bubble oxygenators fallen out of routine clinical use?
- Direct blood-gas interface causes more blood trauma, protein denaturation, and microembolism than membrane oxygenators
- In a hollow fiber membrane oxygenator, does blood flow inside or outside the fibers?
- Blood typically flows outside the fibers while sweep gas flows through the fiber lumens
- What component of the CPB circuit warms and cools the perfusate?
- The heat exchanger
- Where is the heat exchanger most commonly integrated in a modern adult circuit?
- Built into the oxygenator module, upstream of the gas exchange fibers
- What is the function of the venous reservoir in a CPB circuit?
- It collects venous return and shed blood, providing a buffer volume and a site for de-airing before blood enters the oxygenator
- What are the two main reservoir housing designs?
- Hard-shell (rigid, open) reservoirs and soft-shell (collapsible, closed) venous bags
- What is a cardiotomy reservoir used for?
- Collecting, filtering, and defoaming blood suctioned from the surgical field before it returns to the venous reservoir
- What does the defoamer in a cardiotomy reservoir remove?
- Air bubbles and foam introduced by field suction and cardiotomy blood
- What is the purpose of an arterial line filter?
- To trap microemboli (air and particulate) from the oxygenated blood before it reaches the patient
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