502 Exam 2

lbs/2.2

kg =

in x 2.54

cm =

mm x 3

Fr =

((cm x kg)/3600)^0.5

BSA Mosteller =

((kg^0.425)(cm^0.725)) x 0.007184

BSA Dubois

height - 105

IBW female =

height - 100

IBW male =

lbs/1.5(1.1 x IBW)

MO ratio =

greater than 1.0

morbid obesity ratio value that signals morbid obesity

1.3

when calculating BSA for a morbidly obese patient, multiply IBW by

2.0-2.6

typical adult CI

BSA x CI

Q =

V2C2

V1C1 =

weight x average blood volume

EBV =

65 mL/kg

female average BV

70 mL/kg

male average BV

(BV x Hctpre)/(BV + PV + CPB + ANES - urine)

est. Hct =

(BV(Hctpre) + 0.75(PRBCvol))/(BV + PV + CPG + PRBCvol)

Hctpost =

PRBCvol/300 mL

PRBCunits =

EDV - ESV

SV (requiring echo) =

CO/HR

SV =

HR x SV

CO =

CO/BSA

CI =

SV/EDV

EF =

gas flow/Q

gas:blood flow ratio

(systolic + (dialostilic x 2))/3

MAP

((MAP - CVP) x 80)/CO

SVR =

800-1500 dynes/sec/cm^-5

normal values for systemic vascular resistance

250-350 dynes/sec/cm^-5

normal pulmonary vascular resistance

rate pressure product

used in cardiology and exercise physiology to determine the myocardial workload

<12000

normal rate pressure product value

stroke work index

measurement of the work done by the heart

36-49 mL/m^2/beat

normal stroke work index volume

left ventricular stroke work index

measurement of work done by the LV to eject a volume of blood

50-62

normal left ventricular stroke work index value

((base excess) x kg)/4

NaHCO3 =

(K+desired(Bpart + Cpart)) - ((Bpart x K+patient) + (Cpart x K+crystalloid))

K+to add =

((base deficit) x kg)/4

NaHCO3 =

300-450 units/kg

typical heparin loading dose

kg x units of heparin

heparin loading dose =

heparin loading dose/(ACTpost - ACTpre)

HDR =

heparin bolus

used to determine amount of heparin to give to reach a target ACT

(ACTtarget - ACTcurrent) x HDR

heparin bolus =

(HDR(ACTcurrent - ACTbaseline) x 1.3)/100

protamine =

oxygen capacity

total amount of oxygen (bound and dissolved) in 100 mL of blood

(1.34 x Hgb x SaO2) + (0.003 x pO2)

CaO2 =

(1.34 x Hgb x SvO2) + (0.003 x pO2)

CvO2 =

1.34 x Hgb(SaO2 - SvO2) x Q x 10

O2 transfer =

(CaO2 - CvO2) x Q x 10

VO2 =

CaO2 x Q x 10

DO2 =

VO2/DO2

O2ER =

O2 extraction ratio

oxygen consumed vs oxygen delivered

~25%

normal O2ER on CPB

greater than or equal to 3x higher than VO2

DO2 should be maintained here on CPB

50% or higher

anaerobic metabolism and eventual tissue death occurs when O2ER reaches

phase 4

Na+, Ca2+ channels closed, open K+ rectifier channels keep TMP stable at -90mV

Phase 0

rapid Na+ influx through open fast Na+ channels

Phase 1

transient K+ channels open and K+ efflux returns TMP to 0 mV

Phase 2

influx of CA2+ through L-type Ca2+ channels is electrically balanced by K+ efflux through delayed rectifier K+ channels

Phase 3

Ca2+ channels close but delayed rectifier K+ channels remain open and return TMP to -90 mV

radial, brachial, femoral

sites for systemic arterial pressure line

low volume

low PCWP and low cardiac output diagnosis

high volume

high PCWP and normal cardiac output diagnosis

LV failure

high PCWP and low cardiac output diagnosis

papaverine

used as dilator to prevent arterial spasming, sprayed on IMA

20-24 Fr

typical adult aortic arterial cannula size

within first 10 minutes

when is first ABG drawn on bypass

60 minutes

maximum time between ABGs on bypass if in-line blood gas monitoring is available

SvO2

most desired value obtained from VBG

3-5 minutes

how long after administration of full dose or subsequent doses of heparin is ACT drawn

every 30 minutes

how frequently is ACT drawn after heparin is given

4-15 C

cold cardioplegia temperature

250-350 mL/min

antegrade cardioplegia flow

150-200 mmHg

antegrade cardioplegia line pressure

150-250 mL/min

retrograde cardioplegia delivery

40 mmHg

coronary sinus pressure during retrograde delivery

flow and pressure, reservoir level, line pressure, anticoagulation, blood gas values, hemodynamics, urine output

perfusion scan

15-20 min

cardioplegia typically given every

normal sinus rhythm, normothermic, blood gases within normal limits, electrolytes within normal limits, hemoglobin and hematocrit within normal limits, adequate reservoir volume, anesthesia ventilating

termination checklist

18-27 units

normal BMI