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?
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Roller pumps and centrifugal pumps- What is the main advantage of a centrifugal pump over a roller pump?
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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?
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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?
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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?
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Membrane oxygenators and bubble oxygenators- What is the current standard oxygenator design used in nearly all adult CPB circuits?
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The hollow fiber membrane oxygenator- Why have bubble oxygenators fallen out of routine clinical use?
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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?
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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?
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The heat exchanger- Where is the heat exchanger most commonly integrated in a modern adult circuit?
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Built into the oxygenator module, upstream of the gas exchange fibers- What is the function of the venous reservoir in a CPB circuit?
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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?
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Hard-shell (rigid, open) reservoirs and soft-shell (collapsible, closed) venous bags- What is a cardiotomy reservoir used for?
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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?
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Air bubbles and foam introduced by field suction and cardiotomy blood- What is the purpose of an arterial line filter?
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To trap microemboli (air and particulate) from the oxygenated blood before it reaches the patient
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