The Genesis of a BLOG

Across the Water Becomes a Man … Welcome to Circuit Surfers! When I got into the field of Perfusion, the newest technology was the membrane oxygenator (The Maxima from Medtronic) and a new voice mail system put into place by the founder of a tremendous perfusion group called PSICOR. 90 T’s (Datascope Balloon Pumps) were […]

Surfers’ 5 YEAR Anniversary! Retro to Feb 2011: Saturday Morning Brunch I

The European Contingent

A RETRO look at the second post on Circuit Surfers (Feb 25th 2011).  Where are all the RED dots? Editor’s Note: I chose the 2nd post because the 1st one was to put it mildly- somewhat embarrassing. It’s like re-reading something you wrote back in 6th grade embarrassing. What is NOT embarrassing, is that over […]

The “How & Why …” (1st Official ‘Surfers Post)

This is a forum for discussion, a reservoir for perfusion related information, trends, and updates. The intent of this blog is to allow the perfusion community to stay mainstream with current media innovations and directions. Any and all contributions are welcome, Article and post submissions are welcome as well. You can search for posts or […]

Angiomax

Angiomax Perfusion Issues Reconstitute Angiomax in OR- 250 mg in powder with 5 cc NSS=  50 mg per ml. No heparin coated surfaces (circuit, CDI, Swann Ganz– etc) Angiomax ½ life = 25 minutes Will precipitate if blood is allowed to pool Observed clot in the pericardium (after Angiomax is bolused)  is Normal- remove with […]

Myocardial Flow & Oxygen Supply

Myocardial Flow & Oxygen Supply   Vessels on the epicardial surface of the heart are considered to be conductance vessels and under normal conditions offer little resistance for blood flow and perfusion. The four factors influencing blood flow and resistance dynamics for intramural coronary vasculature are:  aortic root pressure, extravascular compression, myocardial metabolic requirement, and […]

Cardiac Conduction System

Normal Conduction System Function 1. To generate rhythmical impulses. 2. To conduct the impulses throughout the myocardium. Normal Conductive Tissue Specialized muscle tissue that is not or poorly contractile. Sinus node (SA Node) –pacemaker of the heart. Internodal pathways–conductive tissue from SA node through atrial muscle. Bachman’s bundle–interatrial internodal pathway–communicates with the right and left […]

Depolarization- Repolarization

Depolarization- Repolarization Resting membrane Potential (RMP) Electrical potential of cell at rest.  Above example is cardiac muscle tissue. Action Potential The five – phase process characterized by the movement of K+, Na, and Ca++( primarily) across cell membrane. Threshold potential (TP) The point at which a stimulus will initiate a response helps determine Automaticity of […]

Cryoprecipitate v1.0

Cryoprecipitate Cryoprecipitate contains 2 or more times the concentration of fibrinogen contained in plasma as well as increased levels of factor V and factor VIII.   Each unit however, contains only 50 ml, thus conceivably requiring several units of cryoprecipitate to be administered in order to achieve target ranges (>150 mg/dl) for depleted fibrinogen levels.  This […]

Desmopressin v.1

Desmopressin Desmopressin acetate (DDAVP) is a synthetic analog of vasopressin and like ADH, epinephrine, and insulin, releases a variety of hemostatically active substances from vascular endothelium.  It is administered in doses of 0.3 µg/kg by intravenous, intranasal, or subcutaneous routes.  It has a half life of 55 minutes, (with clinical effects lasting from 5 to […]

Protamine v1

Protamine   A polycationic protein derived from salmon milt, possess strong alkalinity because of an amino acid composition consisting of 67% arginine.  In its natural state, the numerous positive charges on the protamine molecule bind with the negatively charged phosphate groups of the nucleoprotein material of salmon sperm.  Heparin, a polyanion, binds ionically to protamine […]

Aortic Stenosis v.1

Aortic Stenosis Rheumatic heart disease and calcification deposits due to age (senile calcific aortic stenosis) are the most common pathologic conditions associated with aortic stenosis.  Congenital malformations such as a bicuspid aortic valve with a small annulus, or unicuspid valve usually develop symptoms at an early age but occasionally surface in later years.  Calcification of […]

Cardiac Blood Flow & O2 Consumption v1.0

Cardiac Blood Flow & O2 Consumption   Source: Cardiovascular Physiology Concepts Richard E. Klabunde, PhD The major vessels of the coronary circulation are the left main coronary that divides into left anterior descending andcircumflex branches, and the right main coronary artery. The left and right coronary arteries originate at the base of the aorta from openings called the coronary ostia located behind […]

Intracardiac Shunts v1.0

Principles of Intracardiac Shunts With the continued presence of a congenital defect of the cardiac septum or great vessels in which there is a communication between the left and right cardiac structures, blood flow is diverted from the area of greater resistance to the chamber or vessel of least resistance.  As a result, a percentage […]

Mitral Insufficiency v.1

Mitral Insufficiency Six anatomical components must mesh synchronously to insure proper function of the mitral valve.  Disruption of the kinetic interrelationship between the left ventricular wall, the left atrial wall, valve leaflets, annulus, chordae tendineae, and papillary muscles, may lead to dysfunction of the valve.  Chronic mitral valve insufficiency (regurgitation) most often results from rheumatic […]

Myocardial Ischemia v.1

Myocardial Ischemia Prevention and treatment of perioperative myocardial ischemia is a primary consideration.  Two consistent factors associated with the pathogenesis of myocardial ischemia are inadequate oxygen supply to the myocardium due to localized coronary lesions, and excessive oxygen demand due to increased hemodynamic workload associated with increased heart rate, blood pressure, or adrenergic stimulation of […]