♥
Perfusion Nexus
CPB Simulation Lab
— Choose a scenario —
🔴 Routine CABG (Standard)
⚠️ Redo Sternotomy (Adhesions)
⚡ Aortic Dissection (Emergency)
🔵 Aortic Valve Replacement (AVR)
🟣 Mitral Valve Repair/Replacement (MVR)
💚 ASD / VSD Repair (Congenital)
🫀 MICS / Minimally Invasive
🆘 TAVR Complication (Crash on Pump)
👶 Pediatric VSD Repair
🫁 ECMO Cannulation (ECPR)
🧠 Arch Replacement (DHCA)
James R.
PRE-BYPASS
00:00
3-vessel CAD — elective CABG
📡
Patient Monitor
OFF BYPASS
ECG
ART
HR
68
bpm
MAP
76
mmHg
CVP
8
mmHg
PAP
24
mmHg
SvO₂
75
%
ACT
118
sec
CORE
36.8
°C
CI
—
L/min/m²
DO₂
—
mL/min
DO₂i
—
mL/min/m²
O₂ER
—
%
PVR
—
WU
Urine Output
0
mL
⏱ Check ACT
🌡️
Myocardium
Myocardial Temperature
XC: 00:00
36.8
MYOCARDIAL °C
37.0
BLOOD °C
0.0
GRADIENT
Target 10–15 °C during cardioplegia • Give CP after cross-clamp to cool & arrest
🧪
ABG
Draw
pH
7.40
PaO₂
95
PaCO₂
40
BE
0.0
SaO₂
98
Hct
36
Hb
12.0
K⁺
4.0
Na⁺
140
iCa
1.15
Mg⁺⁺
1.8
Glu
118
Lac
1.2
Cl⁻
104
HCO₃
24
🧠
Cerebral Oximetry (NIRS)
Baseline: 68% / 67%
Left
68%
Right
67%
◎ Set Baseline
💉
Anesthesia Control
Isoflurane (MAC)
1.0%
−0.2
+0.2
CPP (MAP − CVP)
68 mmHg
Target:
>60 mmHg
⚙️
Heart-Lung Machine
1800
mL
Normal
+500 cryst
+250 Albumin
+500 Albumin
−200 UF
🩸 Cell Saver
Bowl:
0
mL
Collect 200 mL
Collect 500 mL
⚙ Process Bowl
↩ Return to Reservoir
Processed RBC:
0
mL ready · Collect shed blood → process → return washed RBCs (↑ Hct)
0.0
L/min
Target CI 2.4 – 4.8 L/min · BSA 1.9 m²
−0.5
−0.1
+0.1
+0.5
Sweep
2.0
L
−
+
FiO₂
60
%
−
+
H/C Temp
37.0
°
−1
−
+
+1
37° Normotherm
32° Mild
28° Moderate
20° Deep
18° DHCA
VAVD OFF
More vac
Less vac
0
mmHg
Typical −20 to −40 mmHg. Chatter if too deep.
Venous Clamp
CLOSED
Aortic X-Clamp
OFF
Give heparin and confirm ACT ≥ 400 before opening the venous clamp.
🩸 Pump / Cardiotomy Sucker
OFF
OFF
→ ANTEGRADE (Aortic Root)
← RETROGRADE (Coronary Sinus)
🌡️
Myocardial Temp during Cardioplegia
36.8 °C
Not cooled
Target <15 °C for protection
▶ START INFUSION
■ STOP INFUSION
Aortic Root Pressure
—
mmHg
Root Vent Status
VENT OFF
Volume Delivered
0
mL
VENT CONTROLS · Manual control — Aortic Root & LV Vents
💙 AORTIC ROOT VENT
▶ VENT ON
■ VENT OFF
Status: OFF
Use with antegrade cardioplegia
💜 LV VENT
▶ VENT ON
■ VENT OFF
Status: OFF
Prevents LV distension
Cardioplegia Additives
K+ 30
Mg++ 5
Lidocaine
🔥 Hot Shot Components
Lidocaine 100mg
Magnesium 2g
🔥 Administer Full Hot Shot
💊
Interventions
Vasopressors / Inotropes
Phenylephrine 100mcg
Norepinephrine 0.05
Epinephrine 0.5
Vasopressin 2u
Milrinone 0.5
Dobutamine 5
Vasodilators
Nitroprusside 0.5
Nicardipine 2mg
NTG 50mcg
Anticoagulation
Heparin 300u/kg
Protamine 50mg
AT-III
💉 Heparin Management
Weight-based Heparin Dose
400 u/kg (Full Dose)
300 u/kg (Standard)
200 u/kg (Low Dose)
82 kg × 400 = 32,800 U
Give Calculated Dose
+5,000 Units
+10,000 Units
+2,000 Units
Total Heparin Given:
0
units
Electrolytes / Blood / Metabolic
CaCl₂ 1g
MgSO₄ 2g
NaHCO₃
Lasix 20mg
Insulin 10U
D50 25g
PRBC 1U
FFP 1U
⚡
Training Events
Hypotension
Hypertension
Low SvO₂
Air Entrainment
Cerebral Malperfusion
Low Reservoir
Acidosis
High Bleeding
📋
Event Log
Clear
00:00
Case loaded: James R. — 3-vessel CAD — elective CABG