The bypass plan

Abstract

The perfusionist must be familiar with the patient's original diagnosis, catheterization lab interventions, previous surgeries, and current needs when developing the bypass plan. The following are major considerations for management of the patient during cardiopulmonary bypass. Please refer to Chapter 6 for defect-specific considerations.The care team must have a reasonably standardized communication plan for the bypass run [1][2][3]. This includes standardizing to closed-loop communication for certain anesthesia, surgical, and cardiopulmonary bypass (CPB) commands, notifications, and/or concerns. Each communication should be verbally acknowledged per the team standard (either repeated back or with another affirmation) to ensure the information is properly delivered and handled. This technique is essential for bypass safety and is used at most centers to announce checkpoints during the case.Common bypass-related checkpoints where closedloop communication among the team is essential include the following: • Heparin in • ACT running • Bypass lines clamped and ready for division at the field • Pump suckers on (with suckers and vent line tested under saline at field)