Cardiopulmonary Considerations for Cardiac Surgery in Low and Middle Income Countries

To accomplish a successful cardiac surgery, cardiopulmonary bypass (CPB) is often utilized to give the surgeon a bloodless field while keeping the patient hemodynamically stable. The perfusionist is responsible for running the heart-lung machine and other devices such as: cell savers, anticoagulation and blood gas management or mechanical circulatory support. Critical times during CPB include going on, cross clamp on and off, cardioplegia delivery, and termination. Troubleshooting is a component that is often overlooked but can be detrimental to delivering the best patient care. To help eliminate these errors, checklists and protocols are put into place to make sure standardized measures are taken pre/intra/post CPB. Safety techniques like deep hypothermic circulatory arrest is performed for certain cardiac surgeries to prevent end organ damage. Perfusion technology is constantly evolving; however, this chapter looks to help build a solid foundation for understanding CPB and supporting devices.