外科学教学课件：体外循环

1 Definition 2 Basical equipments 3 Essential steps 4 Clinical application 5 Pathophysiology 6 Postoperative treatment
Cardiopulmonary Bypass
Drains venous blood from the right atrium or vena cava by the cannula inserted into the venous system.Finishs gas exchange process including oxygen and carbon dioxide by the artifial lung(oxygenator) to change the oxygen poor venous blood into the oxygen rich arterial blood.Pumps oxygenated blood back to the body by the artificial heart(pump) via arterial cannula to remain the living of the all the other organs of the body except the lung and the heart. Provides a limited 2-3 hours time during which the lung and the heart are not working for cardiac surgeon to open the heart and finish a operation precisely with bloodless and motionless field.
2 Methods: 1) Drain out venous blood 2) Oxygenated by artificial lung 3) Oxygen-rich blood pumped back by artificial heart
History Landmark in cardiac surgery!
used in the treatment of heart disease for open intracardio surgery.
Using bionics principle of hibernation，lowering the body temperature can strengthen the tolerance ablility for hypoxia. Decreasing 1 ℃ of the body temperature can reduce oxygen consumption by 5%-6%. Decrease the body temperature to 28 ℃ -20 ℃, the metabolization will be reduced to 50%-80%. Therefore, low temperature can enhance the body tolerance to hypoxia. Combine the cardiopulmonary bypass and hypothermic anesthesia together widely
To repair the cardiac defects Bloodless field Motionless field
Stop the motion of the heart and lungs
Bloodless? Motionless?
Life maintenance?
Cardiopulmonary Bypass
Basic equipments 1 artificial heart (blood pump) 2 artificial lung (oxygenator) 3 temperature exchanger 4 filter 5 tubes or cannulas
Artificial hypothemia
By this way,the function of the lung and heart had been taken over by the extracorporeal circulation equipments. Provide the desired bloodless, motionless operative field and still supply all the other organs of the body with oxygen and nutrient-rich blood.
Heat exchanger
Leabharlann Baidu
Summary for CPB
1 Purpose: 1) To provide a bloodless, motionless field for heart surgery 2) Rest of body perfused while heart and lung stopped
Cardiopulmonary Bypass
Congenital heart disease,Tetralogy of Fallot 6 years old,15 kg weight. cyanosis,clubbing fingers.
wouldn’t grown-up unless recieved cardiac surgery
Western countries in 1953 China in 1958
The hospital here 1963 1979
John H. Gibbon
吴英恺
1 Definition 2 Basical equipments 3 Essential steps 4 Clinical application 5 Pathophysiology 6 Postoperative treatment