ADEQUACY OF

PERFUSION
Made By: Ayesha Qadri
Roll no: 1318063
5th Semester 3rd Year
Perfusion Sciences
Question 1: What do you mean
by adequacy of perfusion?
PERFUSION:
It is a process in which
oxygenated blood is carried to the
tissue.
OR
It is also referred as the
ability of cardio vascular system to
supply adequate blood to tissue to fulfill
their functional demand.
 ADEQUACY OF PERFUSION
It means that blood provide nutrients
to meet the demand for maintaining
healthy vital tissues and remove cellular
waste.
Question 2: What are the
general considerations related
to adequate perfusions?
GENERAL CONSIDERATION:
To maintain adequate perfusion following things
should be consider
• MAP :
In mild to moderate hypothermia
Infant :> 60mmHg
Normal adult: 60 – 70 mmHg
Adult with CAP, DM and Old age :>60 mmHg
• PUMP FLOW RATE:
In normal body temperature
Adult: 2.2 ~ 2.8 L/m2 .min
Infant: 2.6 ~3.2 L/m2 .min
 In hypothermia
Adult: 1.6~2.2 L/m2 .min
Infant: 2.0 ~2.4 L/m2 .min
Adjust according to SVO2 and MAP
• OXYGEN SATURATION SHOULD BE NORMAL
• URINE OUTPUT
• ACT >480 sec
• ABGs
Question 3: What are the
parameters ensure adequate
perfusion?
PARAMETERS:
• Oxygen Consumption
• Mixed Venous Saturation > 75%
• Hemodilution
• Temperature
• pH (7.35 – 7.45 )
• pCO2 (35 -45 mmHg )
• pO2 (150 -250 mmHg )
• PVO2 and SVO2 are good markers for
adequate perfusion
• ACT (coagulation status)
Question 4:What are the
specific aspects of perfusion?
SPECIFIC ASPECTS:
 Oxygen supply
 Invasive arterial pressure is necessary
to detect changes that occur rapidly
during non pulsatile flow on CPB
 Urine output should be 0.5 to 1
ml/kg/min
 Systematic blood flow pressure
depends upon venous compliance
and SVR
 Pharmacological drugs
Question 5: Discuss briefly
important axis of monitoring
during CPB?
AXIS OF MONITORING:
• Reservoir level
• Blood flow at proper rate
• Patient arterial pressure 50 – 90 mmHg
• ECG
• Temperature probe
• CVP 2 – 8 mmHg
• MAP 70 – 90 mmHg
• Pulse oximeter
• Venous oxygen saturation 65-75 %
• Vascular resistance
Question 6: What are the
concomitant factors that affect
the adequacy of CPB?
HYPERTENSION:
• High pressure may cause leaking around
cannulation sites and sutures.
• Nitroprusside is a vasodilator used in bypass.
• It cannot be given faster than 10mcg/kg/min.
HYPOTENSION:
• Cerebral flow is auto regulated when mean
arterial pressure is above 60mmHg the
circulating catecholamine’s level becomes less
during bypass due to dilution arterial pressure
drop SVR reduces and cause hypotension.
TEMPERATURE:
• Priming solution is being warmed before
bypass to prevent from heart fibrillation due to
cold solution.
• Metabolic oxygen consumption is decrease
with cooler temperature.
RENAL FUNCTION:
• Kidney is the first organ suffering if cardiac
output or blood flow decrease.
• If urine output is 0.5 -1.0 ml/kg/hr
then it is a good indicator of adequate
perfusion.
Reference:
THE MANUAL OF CLINICAL PERFUSION

Link: https://hemedex.com/why-perfusion/