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Medindia » Surgical Procedure

Cardiopulmonary Bypass

Medically Reviewed by Dr. Simi Paknikar, MD on May 26, 2017


What is Cardiopulmonary Bypass?

The cardiopulmonary bypass machine is a device which is used in open heart surgeries to support the body when the heart is stopped. It functions like both the heart and the lung; it oxygenates the blood and pumps the blood to the body during surgeries on the heart. It is also referred to as the heart-lung machine or the pump.


The device was used successfully for the first time during an open heart procedure by Dr. John Gibbon in 1953.

The device receives the deoxygenated blood from the body through cannulations and tubes connected to veins, oxygenates it and pumps back the oxygenated blood to the body. The cardiopulmonary bypass (CPB) has 2 main components, the pump and the oxygenator. The components are interlinked through silicone or polyvinyl chloride (PVC) tubes.

1. Pumps: The blood is delivered from the CPB machine to the body through pumps.

2. Oxygenator: The oxygenator oxygenates the blood received from the body as well as removes some carbon dioxide. There are various types of oxygenators that have evolved. Disc and bubble oxygenators that were used earlier have fallen out in favor of the safer membrane oxygenators.

3. Cannula: There are many cannulae inserted into arteries and veins to aid in collecting and supplying the blood to the heart.

When is Cardiopulmonary Bypass Used?

The following are a few procedures during which CPB is used.

Cardiopulmonary Bypass and Hypothermia:

Cardiopulmonary bypass device can also be used to maintain hypothermia or low body temperature during cardiac surgeries. Hypothermia decreases the oxygen consumption by the heart, increases the protection and also the tolerance of vital organs like the brain for ischemia (reduced oxygen supply). The CPB can be used to bring the temperature to normal levels in patients with hypothermia.


What are the Risks & Complications of Cardiopulmonary Bypass?

The risks and complications associated with cardiopulmonary bypass procedure include the following:

The consequences of the CPB can be reduced by the following means -

Pharmacological agents to reduce the effects on the inflammatory and fibrinolytic system include aprotinin, anti-fibrinolytic agents, corticosteroids, anti-oxidants, ACE-inhibitors, monoclonal antibodies and phosphodiesterase inhibitors.

Heparin is used to prevent clotting of blood, and protamine sulfate is used to reverse the anticoagulation.

Cell salvage devices may be used in order to remove the activated blood components and emboli from the blood suctioned at cardiotomy.

References:

  1. Cardiopulmonary bypass - (https://en.wikipedia.org/wiki/Cardiopulmonary_bypass)
  2. Stoney WS. Evolution of Cardiopulmonary Bypass. Circulation. 2009;119:2844-2853
  3. Passaroni AC. Cardiopulmonary bypass: development of John Gibbon''s heart-lung machine. Braz J Cardiovasc Surg 2015;30(2):235-45
  4. Machin D, Alsager G. Principles of cardiopulmonary bypass. Continuing Education in Anaesthesia, Critical Care & Pain 2006; Volume 6 Number 5

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