PER 6220 - Clinical Extracorporeal Perfusion II

• Explain the theoretical underpinnings and practical applications of myocardial protection 
• Describe the various solutions and arrest methods utilized for cardioplegia 
• Describe the various delivery routes for cardioplegia administration and the benefits and drawbacks for each. 
• Diagram the coagulation cascade and complement system 
• Describe the role of platelets in normal physiology and how they are impacted during CPB 
• Discuss challenges resulting from blood surface interface and ways to minimize its detrimental effects 
• Exhibit knowledge of the pharmacology of anticoagulants and procoagulants 
• Diagnose heparin resistance and differentiate it from antithrombin III deficiency 
• Discuss the mechanism of heparin induced thrombocytopenia (HIT) and explain how to manage this type of patient during CPB 
• Explain the process and possible deleterious effects of heparin neutralization via protamine sulfate (e.g. protamine reactions and treatment options) 
• Discuss the impact of CPB on the following systems: pulmonary, renal, splanchnic, hepatic, viscera, and neurologic 
• Describe the endocrine, metabolic, and electrolyte responses to CPB 
• Describe the immune and inflammatory responses associated with CPB 

• Basic principles of clinical perfusion practice

• Myocardial protection and arrest methods  
• Impact of CPB on clotting processes and the complement system 
• Impact of circuit components on blood constituents  
• Use of anticoagulants and procoagulants in cardiovascular patients 
• Impact of CPB on various body systems and processes