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Perfusion Newswirei-Pump Quick ReferenceQuick Reference: Pregnancy and CPB

Quick Reference: Pregnancy and CPB

  1. Use fetal monitoring and position patient with a 30-60 degree left lateral tilt to eliminate IVC compression.
  2. Blood volume of mom is 90-100 ml/kg.
  3. Pregnant patients are typically hypercoagulable.  Check coagulation status frequently.
  4. Avoid femoral cannulation if possible. Bicaval cannulation is preferred.
  5. Use retrograde cardioplegia and scavenge the cardioplegia if possible.
  6. Maintain normothermia unless circ arrest is required (Temp > 32 C).
  7. Maintain HCT > 22%.
  8. Maintain MAP > 70 mmHg.
  9. Increase the FiO2 to maintain PO2 of 400.
  10. Flow at a CI of 2.8-3.2 (Flows should be 20-40% higher than flows used for non-pregnant patient).
  11. Fetal bradycardia is an indication to increase flow and pressure.  
    • Normal fetal heart rate is 120-160 beats/min.
    • Safe range for on CPB is 110-120 beats/min.
Medication Cautions:
  1. Do not use Mannitol because it crosses the placenta.  Use Lasix if diuresis is needed. 
  2. Do not use Neosynephrine.  Use Ephedrine or Dopamine to increase pressure.
  3. Do not use Sodium Nitroprusside.  Use Hydralazine to decrease pressure.

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